Milestone map
Milestone map
3 milestones
Build a physiology knowledge map covering core body systems
3–4 weeks
Produce a comprehensive physiology knowledge map covering the core systems required for clinical practice: cardiovascular (cardiac cycle, blood pressure regulation, Frank-Starling law), respiratory (gas exchange, ventilation-perfusion matching, hypoxic drive, oxygen-haemoglobin dissociation curve), renal (glomerular filtration, tubular reabsorption, acid-base balance, RAAS), neurological (action potential, synaptic transmission, autonomic nervous system), and endocrine (HPA axis, thyroid axis, insulin/glucagon regulation). For each system, your map must capture: the key mechanism, the regulation feedback loop, and a clinical consequence of failure (e.g. what happens when the mechanism fails).
Proof required
Submit your physiology knowledge map (table, concept map, or annotated diagram) covering all five systems with all three dimensions (mechanism, feedback loop, clinical consequence of failure). Present to a qualified examiner for recall testing.
What gets checked
- All five systems are covered — omitting renal or endocrine because they are less intuitive is a common failure.
- Feedback loops are specific — 'negative feedback controls blood pressure' is not a feedback loop; 'increased arterial pressure → baroreceptor stretch → glossopharyngeal/vagal afferents → NTS → decreased sympathetic outflow and increased vagal tone → decreased HR and SVR → reduced CO and BP' is.
- Clinical consequence of failure is specific — 'respiratory failure' is a consequence category, not a specific failure state.
Common mistakes
- Map that describes what each system does without explaining the mechanism — 'the kidney filters blood' is description, not physiology.
- Feedback loops that are one-directional — physiology involves both the activating and the corrective arm of each loop.
- Clinical consequences that are disease names without physiological explanation — 'renal failure occurs' without explaining which mechanism fails and why.
Resources
Foundationstart here
Depthgo deeper
Masteryfor the dedicated
What a verifier looks for
- Ask the student to describe the oxygen-haemoglobin dissociation curve and what shifts it right — tests respiratory physiology.
- Ask what happens to the RAAS in a patient who is dehydrated — tests renal physiology mechanism.
- Ask what clinical sign is an early indicator of autonomic nervous system involvement in a specific condition — tests neurological physiology integration.
Apply physiology to 10 clinical case scenarios
2–3 weeks
Work through 10 clinical case scenarios from published resources (USMLE cases, clinical physiology textbooks, or published OSCE cases). For each case, write a physiological explanation of the clinical findings: link each abnormal sign or symptom to the underlying physiological mechanism. Cases must span at least 4 of the 5 systems from Milestone 1. Include one case where multiple systems interact (e.g. cardiac failure causing both cardiovascular and renal changes).
Proof required
Submit 10 case analyses (1 page each) with clinical sources cited. Cases must span at least 4 systems. One case must explicitly demonstrate cross-system physiological interaction.
What gets checked
- Physiological mechanism is linked to each clinical finding — not just the diagnosis but the physiological chain from mechanism to finding.
- Cross-system case explicitly describes the physiological interaction pathway — 'both systems are affected' is not a cross-system analysis.
- Cases span at least 4 of the 5 systems — 10 cardiovascular cases do not count.
Common mistakes
- Case analyses that name diagnoses without explaining physiology — 'the patient has heart failure' is a diagnosis, not a physiological explanation.
- Cross-system case that names two affected systems without explaining the physiological link between them.
- Cases limited to two or three systems because the others are less familiar.
Resources
Foundationstart here
Depthgo deeper
What a verifier looks for
- Ask the student to explain one clinical finding from their cross-system case using the physiological chain from one system to the other.
- Check that all 10 analyses go from physiological mechanism to clinical finding, not the reverse.
- Ask what systems are represented across the 10 cases — tests that the student hasn't defaulted to familiar territory.
Pass a timed physiology examination under qualified observation
2–4 weeks (study + exam)
Sit a timed physiology examination (minimum 40 questions, 60 minutes) covering all five systems. The examination must be administered by a qualified medical or healthcare educator, clinician, or physiologist with clinical physiology teaching experience. Score of 75% minimum required. The exam is closed-book and timed.
Proof required
Submit your score (75% minimum) and the examiner's signed attestation confirming closed-book timed conditions. Submit a 10-question sample or the full paper if provided.
What gets checked
- Examiner has clinical physiology teaching experience.
- Score is 75% or above.
- Exam is closed-book and timed — examiner attestation required.
Common mistakes
- Examiner without physiology teaching experience.
- Open-book exam.
- Exam limited to two or three systems.
Resources
Foundationstart here
What a verifier looks for
- Confirm the exam was closed-book and timed.
- Verify the examiner has clinical physiology teaching credentials.
- Ask the student to review their incorrect answers — tests learning from the exam.