It’s a challenge to know their level of preparation, as well as their learning styles. But there are resources to help residency program directors (PDs), assistant program directors (APDs), and faculty determine the readiness of their residents to undertake patient procedures — and to assist the residents in acquiring the necessary skills to complete them successfully.
Resident assessment presents obstacles
Internal medicine (IM) residency PDs have limited and often subjective information about the residents seeking to join their programs. Yes, they can look at each candidate’s medical school curriculum and performance. They also have P.R.I.M.E. evaluations. But Dr. Amy Eddy, internal medicine residency program director at Spokane Teaching Health Center, says it’s tough to find objective data in sifting through all the applications.
“Medical students show a variety of preparation when they come to us. We’re trying to determine if each student is at a reporting versus an interpreter versus a manager stage. You always wonder if you’re receiving a true representation of the applicant. COVID made clinical experiences more variable for medical students, so it’s even harder to know what each medical school curriculum included, as well as the school’s expectations. Plus, virtual interviewing has made it more difficult to get a feel for each person and the person to get a feel for our program.”
The National Residency Matching Program® (NRMP®) reports that the 2022 Main Residency Match was the largest in its 70-year history, with 39,205 positions offered and 36,943 positions filled. There’s a lot of room for variability among a cohort of that size!
Numerous procedures required for internal medicine residents
According to the American College of Physicians, resident trainees must be able to competently and safely perform the following medical procedures:
- Advanced cardiac life support
- Arterial and venous blood sampling
- Pap smear and endocervical culture
- Placement of a peripheral venous line
Internal medicine (IM) residents must also understand and be able to explain additional procedures:
- Abdominal paracentesis
- Arterial and central venous line placement
- Incision and drainage of an abscess
- Lumbar puncture
- Nasogastric intubation
- Pulmonary artery catheter placement
But the types and numbers of procedures that IM residents perform vary from hospital to hospital. Dr. Eddy emphasizes that her residents are very procedure-oriented: