Background
Lack of experienced faculty to supervise internal medicine (IM) residents is a significant barrier to establishing a medical procedure service (MPS).
Aim
Describe the development and 10-year outcomes of an MPS led by IM chief residents.
Setting
University-based IM residency program affiliated with a county and Veterans Affairs hospital.
Participants
Categorical IM interns (n=320) and 4th-year IM chief residents (n=48) from 2011 to 2022.
Program Description
The MPS operated on weekdays, 8 am–5 pm. After training and sign-off by the MPS director, chief residents trained and supervised interns in ultrasound-guided procedures during a 4-week rotation.
Program Evaluation
From 2011 to 2022, our MPS received 5967 consults and 4465 (75%) procedures were attempted. Overall procedure success, complication, and major complication rates were 94%, 2.6%, and 0.6%, respectively. Success and complication rates for paracentesis (n=2285) were 99% and 1.1%, respectively; 99% and 4.2% for thoracentesis (n=1167); 76% and 4.5% for lumbar puncture (n=883); 83% and 1.2% for knee arthrocentesis (n=85); and 76% and 0% for central venous catheterization (n=45). The rotation was rated 4.6 out of 5 for overall learning quality.
Discussion
A chief resident–led MPS is a practical and safe approach for IM residency programs to establish an MPS when experienced attending physicians are unavailable.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.