UTHSC College of Medicine Resident Supervision

The Residency Supervision Area is designed to assist hospitals and clinics with the protocols outlined for specific duties residents and fellows can perform. These guidelines are determined by the faculty of the University of Tennessee Health Science Center. Any questions about certain procedures not listed should be addressed to the faculty and not decided by the resident or fellow.

A credentialed and privileged attending physician ultimately provides supervision or oversight of each resident’s patient care activities. Direct supervision by a qualified attending physician is required in the OR/Delivery Room or for non-routine invasive procedures like Cardiac Cath, Endoscopy, and Interventional Radiology. The standards for resident supervision in patient care settings are described on the GME web site: http://uthsc.edu/GME/pdf/supervision2011.pdf.

Mark Trisna

Trisna, Mark - PGY - 3

Department of Medicine & Pediatrics
Resident Supervision


Levels of qualifications for procedures that do not require the presence of an attending physician are listed below:

PGY1 Medicine-Pediatrics residents can perform the procedures marked in yellow.

PGY2 Medicine-Pediatrics residents can perform the procedures marked in red.

PGY3 Medicine-Pediatrics residents can perform the procedures marked in green.

PGY4 Medicine-Pediatrics residents can perform the procedures marked in blue.

All levels of medicine-pediatrics residents can perform the following procedures under general supervision:

PGY1

PGY2

PGY3

PGY4

History

X

X

X

X

Physical

X

X

X

X

Breast Exam

X

X

X

X

Rectal Exam

X

X

X

X

Pelvic Examination, Pap Smear and Wet prep

X

X

X

X

Interpretation of lab studies

X

X

X

X

Interpretation of basic x-ray studies

X

X

X

X

Basic medicine and pediatric cardiopulmonary resuscitation

X

X

X

X

Venipuncture

X

X

X

X

Electrocardiogram performance and interpretation

X

X

X

X

 

If an attending verifies the trainee has achieved competence, PGY 2-4 medicine-pediatrics residents can perform the following procedures under general supervision:

 

PGY2

PGY3

PGY4

Arthrocentesis

 

X

X

X

Joint injection

 

X

X

X

NG tube placement

 

X

X

X

Thoracentesis

 

X

X

X

Lumbar puncture

 

X

X

X

Central line placement

 

X

X

X

Abdominal paracentesis

 

X

X

X

Arterial puncture for ABG collection or catheterization

 

X

X

X

Nasotracheal or orotracheal intubation

 

X

X

X

Pulmonary artery catheter insertion

 

X

X

X

Ventilator management

 

X

X

X

Punch and shave skin biopsy

 

X

X

X

Emergency closed reduction technique and cast application

 

X

X

X

Splinting of fractures and dislocations

 

X

X

X

I&D of superficial abscess and hematoma

 

X

X

X

Infant bladder catheterization

 

X

X

X

Foreign body removal techniques

 

X

X

X

Emergency management of 1st, 2nd and 3rd degree burns

 

X

X

X

Umbilical artery catheterization

 

X

X

X

Umbilical vein catheterization

 

X

X

X

 

All other procedures require direct or personal supervision. It is understood that an emergent procedure may preclude direct supervision if the resident is deemed competent in performing the procedure.

 

NOTE: The policy on resident supervision in the Operating/Delivery Room is described on the GME website: http://www.uthsc.edu/GME/supervisionpolicy.php#operating