The Procedure & Consult Rotation
We believe that appropriate training and experience with core internal medicine procedures is essential for our residents, especially in a medical culture with more and more procedures being done by other subspecialists. Accordingly, we have a required first year rotation and resident procedure team for training in core Internal Medicine procedures. The procedure team performed over 350 procedures in the 2007-2008 residency year, 550 procedures in 2008-2009, and continues to grow.
The Procedure & Consultation Rotation is a 4 week rotation done in the first year of your internal medicine residency. It was started in July 2007 in response to the desire from our residents to have increased exposure to those procedures mandated by the ACGME, and more importantly, those thought to be important in the armamentarium of a practicing internist. The resident on the rotation goes through a methodical training regimen consisting of procedural knowledge acquisition, technical skills acquisition, full simulation training on state-of-the-art ultrasound real simulators in the clinical simulation center, and finally performance of procedures on patients. Throughout all of these steps, the resident receives feedback and assessment by the clinical procedure team staff assuring competency before moving on to the next level of procedures. Formal assessment with multimedia interactive testing tools occurs at various points during the 4 week rotation. There is significant 1-on-1 time between the resident and the procedure rotation staff necessary to adequately teach the intricacies and troubleshooting of the individual procedures.
Bedside ultrasound is becoming an integral part of many procedures, including central lines, paracentesis and thoracentesis. Residents are trained in the use of bedside ultrasound using a portable ultrasound machine owned by the residency program. Our procedure simulators in the simulation center are "ultrasound-real" to give our trainees the most realistic simulation environment.
Additionally, the skill of being an effective internal medicine consultant is an increasingly important part of the hospitalist's role and constitutes an important learning aspect of this rotation during the first year of internal medicine residency.
Click the button below to see the resident procedures homepage with videos, instruction, technique, and other resources available for procedure training.
