Internal Medicine/Pediatrics Program
Medicine Residents Procedure Requirements
Procedures and technical skills
      1. Procedures
          2. 1. All residents must be instructed in indications, contraindications, complications, limitations, and interpretations of findings; they must develop technical proficiency in performing the following procedures:
          • advanced cardiopulmonary resuscitation
          • access techniques to obtain venous and arterial blood
          • abdominal paracentesis
          • thoracentesis
          • arthrocentesis of the knee
          • central venous line placement
          • lumbar puncture
          • nasogastric intubation
        Residents should be instructed in additional procedural skills that will be determined by the training environment, residents' practice expectations, the availability of skilled teaching faculty, and privilege delineation. These procedures may include but are not limited to:
          • arterial line placement
          • bone marrow aspiration
          • bladder catheterization
          • elective cardioversion
          • endotracheal intubation
          • flexible sigmoidoscopy
          • pulmonary artery balloon flotation catheter placement
          • skin biopsy (punch)
          • temporary pacemaker placement
          • ambulatory electrocardiographic interpretation
          • treadmill exercise testing, supervision, and interpretation
          • fitting vaginal diaphragms
          • topical chemotherapy for external genital warts
          • endometrial biopsy
          • insertion and removal of IUDs
      1. Interpretative skills
        1. All residents should be given an opportunity to develop competency in interpretation of:
          • electrocardiograms
          • chest roentgenograms
          • Gram stains of sputum
          • microscopic examinations of urine
          • spirometry
          • KOH and wet prep examinations of vaginal discharge for clue cells, candida, and trichomonas


This material is based on the regulations from the Accreditation Council for Graduate Medical Education (ACGME) procedure regulations, select the appropriate link below.