Physical Examination Practices of Internal Medicine Residents: A Pilot Study

Background Several foundational studies have demonstrated that Internal Medicine (IM) residency programs undervalue physical examination skills and infrequently provide direct clinical oversight of residents as they perform physical examinations. This lack of prioritization is consequential. While the literature assessing the accuracy and completeness of IM residents' physical examinations is relatively narrow, certain studies have demonstrated worrisome deficiencies in their clinical skills. Methodology In this single-institution, exploratory, survey-based pilot study, we queried how IM residents perform examinations and their opinions of their own abilities and the adequacy of their training. Results Our most critical findings were that nearly all residents (98.3%) examined patients while they were fully clothed and 42.1% believed that such examinations were "adequate and accurate." Only around half (51.7%) of respondents reported that supervising physicians routinely return to the examination room with them, and nearly 90% said they are rarely provided beside instruction. While a large majority felt that physical examinations help them develop differential diagnoses and diagnose their patients' conditions, only 58.2% felt confident in their examination skills. Conclusions We hope that this preliminary work will lead to collaborations with other training programs in an effort to better understand the state of IM residents' clinical training.