Development of a Chief Resident Medical Procedure Service: a 10-Year Experience.

Area of Science:

• Medical Education
• Internal Medicine
• Clinical Procedures

Background:

• Lack of experienced faculty is a major obstacle for internal medicine residency programs seeking to establish a medical procedure service (MPS).
• This limitation can hinder resident training in essential procedural skills.

Purpose of the Study:

• To describe the development and evaluate the 10-year outcomes of a novel MPS model.
• This model is specifically designed to be led by internal medicine chief residents.

Main Methods:

• The study involved categorical internal medicine interns and chief residents at a university-based program from 2011 to 2022.
• Chief residents, after training and certification, supervised interns in performing ultrasound-guided procedures during a dedicated 4-week rotation.

Main Results:

• Over 10 years, the MPS handled 5967 consults, with 4465 procedures attempted.
• High success rates (94% overall) and low complication rates (2.6% overall, 0.6% major) were achieved across various procedures.
• Specific procedures like paracentesis (99% success) and thoracentesis (99% success) demonstrated excellent outcomes, with resident learning rated highly (4.6/5).

Conclusions:

• A chief resident-led MPS provides a feasible and safe solution for internal medicine residency programs facing faculty shortages.
• This model effectively facilitates procedural training for residents, ensuring competency and patient safety.