Altru Family Medicine Residency

PROCEDURE DOCUMENTATION 

Family Medicine residents have the opportunity to perform many procedures in both the inpatient and outpatient setting on a number of rotations throughout the course of training.  Each resident will need to track and record all procedures on the current database program.  A printed document of procedural data can be generated and downloaded from this database.  It is the resident’s responsibility to record and maintain the procedure log.  This log book will be the basis for whether or not a resident is given hospital privileges to perform procedures upon graduation.

A database of resident’s clinical and procedural experience, both in hospital and in the ambulatory settings is maintained.  Most privileges are now granted on an experiential basis, so it is essential that this database be maintained accurately, and kept current.  While it is the program’s responsibility to make such a system available, it is the resident’s responsibility to utilize it and enter their procedure activities on the computer. 

Procedures are an important part of family medicine. Reductionism in the practice of medicine frequently "streamlines" procedures that could be easily performed in the office to a custom-built center, which is almost invariably more expensive, and less convenient to the patient, than an office setting.  Notwithstanding, the procedures that a resident should hope to master will inevitably be directed by that resident's eventual practice site and the needs of his/her patient population.  As far as the teaching of procedural skills during residency is concerned, the Program divides them into core, graduation requirement, and elective.  A procedural elective is available.

Residents are required to log all procedures, using the database supplied through E-value.  Each procedure has a “Basic Skills Qualification” describing the procedure and an assessment form to verify procedure competency.  “Basic Skills Qualifications” are available on E-Value or below.  Prior to seeking BSQ certification, a resident should be confident in their skills.  The “Basic Skills Qualification” is printed and given to the supervising physician, where after, the resident performs the procedure under direct observation of the supervising physician.  The competency assessment is completed by the supervising physician with their signature and given back to the resident.  The resident then returns the competency assessment to the Academic Coordinator.


Basic Skills Qualifications

1. Abscess Incision and Draining
2. Amniotomy
3. Anoscopy
4. Basic OB Ultrasound
5. Circumcision
6. Colposcopy with Biopsy
7. Cryotherapy
8. EKG
9. EKG Reading
10. Endometrial Biopsy
11. Endotracheal Intubation
12. FAST Exam
13. Fetal Scalp Electrode (FSE) Placement
14. Fluorescein Eye Exam
15. Ingrown Toenail Removal
16. Injury Management
17. Intrauterine Pressure Catheter (IUPC)
18. IUD Insertion
19. Large Joint Arthrocentesis/Injection – Knee
20. Large Joint Arthrocentesis/Injection – Shoulder
21. Lumbar Puncture
22. Musculoskeletal Ultrasound I (Basic)
23. Musculoskeletal Ultrasound II (Intermediate)
24. Musculoskeletal Ultrasound III (Advanced)
25. Musculoskeletal Ultrasound – Ankle
26. Musculoskeletal Ultrasound – Elbow
27. Musculoskeletal Ultrasound – Hip
28. Musculoskeletal Ultrasound – Knee
29. Musculoskeletal Ultrasound – Shoulder
30. Musculoskeletal Ultrasound – Venous Access
31. Musculoskeletal Ultrasound – Wrist
32. Nexplanon (etonogestrel implant) Insertion
33. Office Spirometry
34. Perineal Laceration Repair
35. Punch Biopsy/Shave Biopsy/Excisional Biopsy
36. Slit Lamp Exam
37. Splinting and Casting
38. Stress Testing
39. Team Travel
40. Vasectomy
41. Wound and Laceration Repair