Procedural Skills of a General Internist - Informed by the Front Line.

Abstract

Debate has occurred over many years regarding the ideal procedural skill set for a graduate of a General Internal Medicine (GIM) training program. A mixed methods study was used to establish a list of mandatory and selective procedural skills for all graduates of a 2-year PGY4/5 GIM subspecialty training program. This list was informed by previous literature, a survey of Canadian Society of Internal Medicine (CSIM) members, and a roundtable discussion at the October 2015 CSIM meeting in Prince Edward Island. The study illustrates the remarkable diversity of practice profiles and procedural skills performed by general internists in Canada. RésuméDepuis nombre d'années, l' ensemble idéal d'habiletés qu'un diplômé d'un programme de médecine interne générale (MIG) doit maîtriser fait l' objet de débats. Une étude à méthodologie mixte a été utilisée pour dresser une liste d'habiletés particulières et obligatoires que doivent maîtriser tous les diplômés de 4 e et de 5 e année d'un programme comportant deux ans de surspécialité en médecine interne générale. Cette liste a été établie à partir de documentation existante, d'un sondage auprès des membres de la Société canadienne de médecine interne (SCMI) et d'une table ronde tenue lors du Congrès de la Société en octobre 2015 à l'Île-du-Prince-Édouard. L' étude montre la remarquable diversité des profils de pratique et des habiletés déployées par les internistes généraux au Canada.Canadian General Internists have had longstanding passionate debates regarding which procedures should be performed competently by graduates of General Internal Medicine (GIM) programs. [1][2][3][4] Previous studies have shown a diversity of procedures performed in practice, with insufficient consensus as to which procedures should be routinely learned by GIM graduates. 3,4 Concurrently literature suggests that Canadian GIM Graduates are not sufficiently prepared to perform procedural skills in practice. 3GIM training is now defined as a 2-year PGY 4/5 program which builds on the "core" internal medicine training programs. Procedural Skills of a General Internist -Informed by the Front LineRodrigo B Cavalcanti MD, MSc, FRCPC, Amy C Hendricks MD, FRCPC, Sharon E Card MD, MSc, FRCPC competence in further procedures. (Table 1). As of 2016, these would be considered mandatory procedural skills for ALL GIM graduates and therefore each GIM program must be able to provide training for proficiency in the skills in Table 1. The GIM documents were deliberately written to allow flexibility in training, ensuring that GIM trainees have the opportunity to train in additional procedures tailored to their future practice setting. Operationally this has been difficult to implement for 2 major reasons: (1) many residents do not know their future practice location in sufficient time to plan procedural training and (2) programs have had difficulty developing multiple elective training opportunities which may or may not be used.The Royal College of Physicians and Surgeons of Canada (RCPSC) has launched the...

A comparative analysis of graduate preparedness for a career in General Internal Medicine before and after national subspecialty recognition to inform curricular changes: have we met the mark?

“…The number of procedures in the 2021 survey is less than the 2006 survey. In an effort to target the most widely and commonly practiced procedures, we only included those that at least 50% of the 2006 respondents reported using at least once per month, 4 all of the procedural skills deemed mandatory for GIM trainees, 7 along with newer practices such as the use of point-of-care ultrasound.…”