Procedural Experience at SFMR 

Core Procedures  

Procedure

Rotation

Expected level of competency

Required number observed

Reading available

Tutorial available

Skin Procedures:

 

 

 

 

 

Punch Biopsy

 

Clinic

Independent

3

Y

Y

Shave Biopsy

 

Clinic

Independent

3

Y

Y

Excisional Biopsy

 

OS2

Independent

3

Y

N

I & D of abscess/cyst

 

Clinic

Independent

3

Y

Y

Sebaceous Cyst removal

Clinic, OS2

Independent

3

Y

N

Digital Block

 

ER, OS2

Independent

3

Y

Y

Cryotherapy - warts, AK, SK

Clinic

Independent

3

Y

Y

GI Procedures  

 

 

 

 

 

Anoscopy

Clinic, Colorectal

Independent

3

Y

N

 

Inpatient Procedures          

Lumbar Puncture 

Peds, ICU, FPIS

Independent

3

Y

N

Arterial blood gas

ER, ICU, FPIS Surgery

Independent

3

Y

N

OB/GYN Procedures

 

 

 

 

 

Normal vaginal delivery

OB

Independent

50

Y

Y

Episiotomy Repair - 1st and 2nd degree

OB

Independent

5

Y

Y

IUPC placement, scalp lead placement, ROM

OB

Independent

3

Y

N

NST interpretation

OB, Clinic

Independent

10 NST's

Y

N

OB ultrasound - 3rd trimester (ALSO)

Clinic

Independent

10

Y

N

Colposcopy with biopsy

GYN Clinic

Independent

10

Y

Y

Orthopedic Procedures

 

 

 

 

 

Splinting of injured limb

Clinic, Sports Med

Independent

3 (each extremity)

Y

N

  

Advanced Procedures:

 

Procedure

Rotation

Expected level of competency

Required number observed

Reading available

Tutorial available

Skin Procedures:          

Ingrown Nail Removal

Clinic

Independent

3

Y

Y

Radiofrequency excision of benign lesions

Clinic

Independent

3

Y

N

Pilonidal Cyst drainage or marsupialization

Clinic

Knowledgeable

3

Y

Y

Curettage and electrodessication of Basal Cell Cancer

Clinic, Derm

Independent

3

Y

N

Urologic Procedures

 

 

 

 

 

Vasectomy

Clinic, Urology

Knowledgeable

5

Y

Y

Circumcision (Neonatal)

Clinic

Independent

3

Y

Y

Catheterization - urethra (male and female

Clinic, L & D, ER

Independent

2

Y

N

ENT Procedures

 

 

 

 

 

Nasolaryngoscopy

OS2, Clinic

Knowledgeable

3

Y

Y

Intubation

OS2, ER

Independent

5

Y

N

Epistaxis Management

ER, clinic

Independent

2

Y

N

Cerumen Impaction

Clinic

Independent

2

Y

N

Thyroid Nodule FNA

Clinic

Knowledgeable

1

Y

N

GI Procedures          
Internal Hemorrhoid Banding Clinic, Colorectal   Knowledgeable 3 Y Y

External Hemorrhoid excision

Clinic, Colorectal

Knowledgeable

2

Y

Y

Flexible sigmoidoscopy

Clinic, Colorectal

Knowledgeable

10

Y

Y

OB/GYN Procedures          

Episiotomy Repair - 3rd Degree

OB

Knowledgeable

3

Y

N

Episiotomy Repair - 4th Degree

OB

Knowledgeable

N/A

Y

N

LEEP GYN Clinic Independent 5 Y Y

Induction and augmentation of labor

OB

Independent

20

Y

Y

IUD insertion and removal

Clinic, GYN

Independent

3

Y

Y

Bartholin's Cyst - Ward catheter placement

Clinic, GYN

Knowledgeable

3

Y

Y

Bartholin's Marsupialization

OS2

Knowledgeable

3

Y

Y

Culdocentesis

Clinic, ER

Knowledgeable

3

Y

N

Norplant insertion and removal

Clinic, OS2

Knowledgeable

3

Y

N

Orthopedic Procedures

 

 

 

 

 

Splinting of injured limb

Clinic, Sports Med

Independent

3 (each extremity)

Y

N

Inpatient Procedures          

Treadmill Testing  

Cardiology

Knowledgeable

3

Y

N

Chest Tube placement

ER, ICU, Surgery

Knowledgeable

3

Y

N

Thoracentesis

FPIS, ER,

Independent

3

Y

Y

Central line placement

ICU, ER

Knowledgeable

3

Y

N

Paracentesis          

Arterial line placement  

ICU

Independent

3

Y

N

  

Definition of competencies:

            Independent:  Resident can be expected to perform well, but may occasionally need assistance with complex or unusual cases.

            Knowledgeable:  Resident has performed in during training but may require proctoring to perform the procedure.

 Required Observations: These serve as the minimum required observations of the resident performing the procedure independent before being considered competent.