Competencies (Table of Procedures)
Below is a table of procedures indicating which procedure a surgical resident may perform, with and without supervision. In all cases the clinical situation, the experience of the specific resident and the judgment of the more senior residents and/or the
Legend
DS = Direct Supervision
IS = Indirect Supervision
O = Oversight
DS/IS = Direct supervision, until competency is achieved, then indirect supervision
I = insertion
R = removal
| PGY | |||||||
|---|---|---|---|---|---|---|---|
| Procedure | 1 | 2 | 3 | 4 | 5 | ||
| airway management, stable/unstable, trauma | DS | DS | DS | DS | DS | ||
| anesthesia | |||||||
| local | DS | O | O | O | O | ||
| field block | DS | IS | IS | IS | IS | ||
| peripheral nerve block | DS | IS | IS | IS | IS | ||
| ankle-brachial index | DS/IS | O | O | O | O | ||
| arterial line (I/R) | DS | DS | DS | IS | IS | ||
| arthrocentesis | |||||||
| lower extremity | DS | DS | DS | DS | DS | ||
| upper extremity | DS | DS | DS | DS | DS | ||
| bladder (Foley) catheter (I/R) | DS/IS | O | O | O | O | ||
| bladder irrigation | DS/IS | O | O | O | O | ||
| blood gases (arterial) | DS/IS | O | O | O | O | ||
| bronchoscopy | DS | DS | DS | DS | DS | ||
| cardiopulmonary resuscitation | |||||||
| closed | DS | DS | DS | DS | DS | ||
| open | DS | DS | DS | DS | DS | ||
| cardioversion | DS | DS | DS | DS | DS | ||
| cast/splint (Ap/R) | |||||||
| for fracture | DS | DS | DS | DS | DS | ||
| for immobilization/protection | DS | DS | DS | DS | DS | ||
| central line (femoral/jugular/subclavian) | |||||||
| insert | DS | DS | DS | DS/IS | DS/IS | ||
| remove | DS/IS | IS | IS | IS | IS | ||
| chest tube | |||||||
| insert | DS | DS | IS | IS | IS | ||
| remove | DS/IS | IS | O | O | O | ||
| colonoscopy, with/without biopsy | DS | DS | DS | DS | DS | ||
| compartment pressure measurement | DS | DS/IS | IS | IS | IS | ||
| conscious sedation | DS | DS | DS | DS | DS | ||
| cricothyroidotomy | DS | DS | DS | IS | IS | ||
| cultures (urine/sputum/wound) | DS/IS | O | O | O | O | ||
| cutdown | |||||||
| venous | |||||||
| insert | DS | DS | DS | DS | DS | ||
| remove | DS/IS | IS | IS | IS | IS | ||
| arterial | |||||||
| insert | DS | DS | DS | DS | DS | ||
| remove | DS/IS | DS/IS | DS/IS | IS | IS | ||
| defibrillation | DS | DS | IS | IS | IS | ||
| Doppler study | |||||||
| venous | DS/IS | O | O | O | O | ||
| arterial | DS/IS | O | O | O | O | ||
| graft/fistula | DS/IS | O | O | O | O | ||
| drug administration | |||||||
| intravenous | DS | IS | IS | IS | IS | ||
| intra-arterial | DS | DS | DS | DS | DS | ||
| esophagogastroduodenoscopy (EGD) | DS | DS | DS | DS | DS | ||
| endotracheal suctioning | DS/IS | IS | IS | IS | IS | ||
| endotracheal/nasotracheal intubation | DS | DS | DS | DS | DS | ||
| gastric lavage | DS/IS | IS | IS | IS | IS | ||
| incision & drainage, abscess/fluid collection/cyst | DS | DS/IS | IS | IS | IS | ||
| laceration repair | DS/IS | IS | IS | IS | IS | ||
| laryngoscopy | DS | DS | DS | DS | DS | ||
| long intestinal tube (I/R) | DS/IS | IS | IS | IS | IS | ||
| lumbar puncture | DS | DS | DS | DS | DS | ||
| mediastinal tube | |||||||
| insert | DS | DS | DS | DS | DS | ||
| remove | DS/IS | IS | IS | IS | IS | ||
| nasal packing | |||||||
| anterior | DS | DS | DS | DS | DS | ||
| posterior | DS | DS | DS | DS | DS | ||
| nasogastric tube (I/R) | DS/IS | IS | IS | IS | IS | ||
| pacemaker/pacer wires, transthoracic | |||||||
| insert | DS | DS | DS | DS | DS | ||
| remove | DS/IS | IS | IS | IS | IS | ||
| pacemaker/pacer wires, transvenous | |||||||
| insert | DS | DS | DS | DS | DS | ||
| remove | DS | DS | DS | DS | DS | ||
| paracentesis/acute PD catheter | DS | DS | DS | DS | DS | ||
| Percutaneoue fine needle aspiration/drainage/biopsy for fluid collection, cyst, abscess, mass | DS/IS | IS | IS | IS | IS | ||
| Peripheral IV (I/R) | DS/IS | IS | IS | IS | IS | ||
| perform/interpret lab tests (spin Hct/do UA/EKG/ | DS/IS | IS | IS | IS | IS | ||
| pericardiocentesis | DS | DS | DS | DS | DS | ||
| peritoneal lavage | DS | DS | DS | DS | DS | ||
| phlebotomy (including blood cultures) | DS/IS | IS | IS | IS | IS | ||
| pleurodesis | DS | DS | DS | DS | DS | ||
| rectal tube (I/R) | DS/IS | IS | IS | IS | IS | ||
| remove foreign body | DS | DS | DS | IS | IS | ||
| sclerosis, other (eg, seroma) | DS | DS | DS | DS | DS | ||
| sigmoidoscopy/anoscopy | |||||||
| with biopsy | DS | DS | DS | DS | DS | ||
| without biospy | DS | DS | DS | DS | DS | ||
| sutures/staples (I/R) | DS/IS | IS | IS | IS | IS | ||
| thoracentesis | DS | DS | DS | DS | DS | ||
| thoracotomy, emergency | DS | DS | DS | DS | DS | ||
| tracheotomy | DS | DS | DS | DS | DS | ||
| wound dressing change/vac change | DS/IS | O | O | O | O | ||
Legend
DS = Direct Supervision
IS = Indirect Supervision
O = Oversight
DS/IS = Direct supervision, until competency is achieved, then indirect supervision
I = insertion
R = removal