Resident delineation of privileges process

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There is no question that each faculty will allow the resident more or
less freedom depending on the ability, skill and knowledge of the
individual resident. However it is always done under supervision. The
latitude of this supervision will vary. Some supervision will be
scrubbed, some observation and some immediately available but not in the
OR. The faculty always has the responsible to assure that patient care
is correct and appropriate

Norman

Norman McSwain MD
Professor - Tulane Univ. SOM
Trauma Director - Charity Hospital
504 988 5111

-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org] On Behalf Of KMATTOX at aol.com
Sent: Wednesday, July 01, 2009 10:32 PM
To: trauma-list at trauma.org
Subject: Re: Resident delineation of privileges process

Norm is correct of course, but there are guidelines on graded  
responsibility under supervision which does allow some graded
independence.    How that 
is achieved is a function of the art  and science form of a teacher and
a 
program.       
 
k
 
 
 
 
In a message dated 7/1/2009 10:18:52 P.M. Central Standard Time,  
nmcswai at tulane.edu writes:

It is  our STRONG belief that surgery residents are physicians that can
do 
what their  license and the state board of examiners allows as they
function 
 independently. However in the teaching hospital they are not
credentialed 
to  do ANY surgical procedures. They are trainees learning to be
surgeons. 
The  faculty are credentialed by the hospital to function as surgeons
and 
MUST  supervise and be responsible for any surgical procedure that is
done for 
the  patients by the residents-in-training. Until the residents
graduate, 
become  board certified and are independently credentialed in their
hospital 
of  choice, they MUST function under the supervision of the staff
surgeons. 
The  residents are not credentialed to do any procedure  independently.
They  
are trainees, not independent practitioners

Norman

Norman  McSwain MD
Trauma Director, Charity Hospital
Professor of Surgery,  Tulane University
New Orleans LA
504 988  5111
norman.mcswain at tulane.edu <mailto:norman.mcswain at tulane.edu>  

________________________________

From:  trauma-list-bounces at trauma.org on behalf of KMATTOX at aol.com
Sent: Wed  7/1/2009 6:41 PM
To: trauma-list at trauma.org
Subject: Re: Resident  delineation of privileges process



Be careful about making such  restrictive proscriptive lists of routine 
things that a licensed physician  routine do.   Remember that residents

are NOT
sub human  primates, but do have institutional license to practice
medicine
and  have judgement.    Internist and pediatricians are  not
credentialled
to do or not to do IVs, lumbar punctures, ordering of  insulin,
ordering of
cardiotonic drugs, ordering of vasoactive drugs,  ordering of  
anticoagulants.
In my experience it would be  much more  important to have the non
surgical personal have a list of  just what they must  be supervised to 
order among
all of the long list  of drugs, than to restrict  surgeons.      Quite
honestly, it appears to me that a PGY1  pediatrician or  internist can 
order drugs
the first day of July of their PGY1  year  that they will be using the 
entire
rest of their life.   

k







In a message dated 7/1/2009 5:10:08  P.M. Central Standard Time, 
Traumamd at nyc.rr.com writes:

Does   anyone have a delineation of privileges for surgical  residents?
Something  that says at what PGY level residents should be  able to do 
routine
procedures and how many they need to do to be  certified to perform  w/o
supervision. Things like foley, CVP, suture  wounds,  etc.
Thanks
Ronald Simon,MD
NYU Medical   Center/Bellevue

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