The One Dozen Most Important Things You May Not Have Known, Understood, or Realized About American Medicine is a series of modules designed to introduce international medical graduates (IMGs) who are entering the U.S. medical education and health care systems to the medical culture in which they will be working. The series includes areas in which IMGs most frequently have questions.

Each module includes:

• A brief narrative description of the topic and its implications
• One or more video scenarios demonstrating interactions and behaviors related to the topic. Some scenarios demonstrate model behaviors, while others clearly demonstrate inappropriate behaviors.
• An analysis of the scenario(s) that highlights specific aspects of the physician’s interactions and behaviors. The analysis acknowledges model behaviors and proposes alternatives to poor behaviors.
• A set of discussion questions. Since the questions are designed to generate discussion (if being used in a group) or provide an opportunity for self reflection (if being used by an individual), answers are not provided.
• A script of the video scenario(s)

Topic Modules:

1. The Doctor-Patient Relationship
2. The Role of the Patient’s Family
3. Confidentiality
4. The Health Care Team
5. America Is a Litigious Society
6. Document, Document, Document!
7. Who Pays the Bills?
8. Gender Issues and Discrimination
9. Safety and Errors
10. Informed Consent
11. U.S. Graduate Medical Education
12. Above All, Professionalism

ECHO also offers a similar set of modules on issues having to do with aspects of medical culture as they relate to pediatric patients and their parents or caregivers: Caring for Kids… and Their Parents!

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