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.

Jelani Teamer

Teamer, Jelani - PGY - 2

Department of Internal Medicine--Nashville
Resident Supervision


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

PGY1 Internal Medicine-Nashville residents can perform the procedures marked in yellow (some procedures require specific credentialing for PGY-1 level trainees).

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

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

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

All levels of internal medicine residents can do the following procedures under general supervision:

PGY1

PGY2

PGY3

PGY4

History

X

X

X

X

Physical Exam

X

X

X

X

Breast Examination

X

X

X

X

Rectal Examination

X

X

X

X

Pelvic Examination and Pap Smear

X

X

X

X

Interpretation of laboratory studies

X

X

X

X

Basic Cardiopulmonary resuscitation

X

X

X

X

Venipuncture

X

X

X

X

Electrocardiogram performance and interpretation

X

X

X

X

 

The following may be done by PGY2/3/4 residents (not fellows) in internal medicine:

 

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

Arterial puncture for ABG collection

 

X

X

X

Nasotracheal or orotracheal intubation

 

X

X

X

Abdominal paracentesis

 

X

X

X

Pulmonary catheter insertion

 

X

X

X

Ventilator management

 

X

X

X

Skin biopsy - punch and shave

 

X

X

X

 

Pgy1 Residents in internal medicine-Nashville may begin performing the following procedures when they have documented competence with the following numbers:

PGY1

Arthrocentesis

(5)

Joint injection

(5)

NG tube placement

(5)

Thoracentesis

(5)

Lumbar puncture

(5)

Central line placement

(5)

ABG collection

(5)

Intubation

(5)

Paracentesis

(5)

PA catheter insertion

(5)

 

All other procedures require direct or personal supervision. It is understood that emergent procedures may require performance by whatever personnel are available.

 

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