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Procedural experience and comfort level in internal medicine trainees
C M Hicks1, R Gonzalez, M T Morton
1Division of General Internal Medicine, University of Colorado Health Sciences Center, Denver, USA.
Journal of General Internal Medicine
|November 23, 2000
Summary
Internal medicine residents often need more procedures than the American Board of Internal Medicine (ABIM) minimums to feel comfortable. Re-evaluating these minimum standards is crucial for ensuring resident competence and procedural comfort.
Area of Science:
- Medical Education
- Internal Medicine Training
- Procedural Competency
Background:
- The American Board of Internal Medicine (ABIM) sets minimum procedure numbers for resident competence.
- These standards are based on expert consensus and may not reflect actual comfort levels.
Purpose of the Study:
- To determine the number of procedures at which internal medicine residents feel comfortable performing them.
- To compare resident comfort thresholds with ABIM minimum standards.
Main Methods:
- A cross-sectional survey of 232 internal medicine residents from military, community, and university programs.
- Survey assessed procedures performed, comfort levels, and desire for further training.
- Comfort threshold defined as the number of procedures where ≥2/3 of respondents felt comfortable.
Main Results:
- Residents felt comfortable with 3/7 procedures at or below ABIM minimums.
- More procedures were needed for comfort in central venous line placement, knee aspiration, lumbar puncture, and thoracentesis.
- Increased procedures performed, years of training, and male gender were associated with greater comfort.
Conclusions:
- ABIM minimum procedural standards may require re-evaluation based on resident comfort.
- Some advanced residents lack experience in common ambulatory procedures.
- Resident comfort levels should be considered in certifying competence.
