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Procedures

Internal Medicine/Pediatric residents are expected to be familiar with the following procedures. Required procedures are specified by the American Board of Internal Medicine (ABIM) and American Board of Pediatrics (ABP) respectively. Please note that some procedures double-count for both specialties; these are indicated in the Pediatrics section (see notes for details).

Internal Medicine

REQUIRED SKILLS:

Drawing Venous Blood (5) Drawing Arterial Blood (5)
Placing a Peripheral Venous Line (5) Central venous access (5 total):
Femoral
Subclavian
Internal jugular
Abdominal Paracentesis (5) Thoracentesis (5)
Lumbar puncture (5) Pap smear and Endocervical Culture (5)

Note: () -- indicates minimum number of procedures required by the ABIM

ELECTIVE SKILLS:

Arterial puncture (5) Arterial line insertion (3)
Arthrocentesis (5) Bone Marrow biopsy and aspiration (3)
Chest tube insertion (5) Cryosurgical removal of skin lesions (3)
Endotracheal intubation (5) Elective cardioversion (2)
Nasogastric tube insertion (5) Sigmoidoscopy:
Flex (10)
With biopsy (2)
Skin biopsies (2) Soft tissue and joint injections (2)
Swan-Ganz catheter placement (10) Temporary pacemaker insertion (5)
Treadmill exercise test (5) Upper GI endoscopy (10)

Pediatrics

REQUIRED SKILLS:

Arterial Puncture [+] Basic and Advance Life Support
Bladder Catheterization [+] Developmental Screening Test
Endotracheal Intubation [+] Gynecologic Evaluation of Pre- and Postpubertal Females [O+]
Lumbar Puncture [+] Pain Management besides Procedural Sedation
Placement of Intraosseous Lines (Demonstration in a skills lab or PALS course is sufficient) Placement of Intravenous Lines
Procedural Sedation Reduction and Splinting of Simple Dislocations/Fractures
Subcutaneous, Intradermal, and Intramuscular Injections Umbilical Artery & Vein Catheterization
Venipuncture [+] Wound Care and Suturing of Lacerations [O+]

Note:
 O -- Med/Peds residents may use procedure performed on adult to meet requirement for Pediatrics
+ -- Med/Peds residents may use to meet procedure requirements for Internal Medicine

ELECTIVE SKILLS:

Chest Tube Placement [O+] Circumcision
Hearing Screening Incision and Drainage of Superficial Abscess
Inhalation Medications Simple Removal of Foreign Bodies (e.g., from ears/nose)
Thoracentesis [O+] Tympanometry and Audiometry Interpretation
Vision Screening

Note:
 O -- Med/Peds residents may use procedure performed on adult to meet requirement for Pediatrics
+ -- Med/Peds residents may use to meet procedure requirements for Internal Medicine

Last modified: Sep 13, 2019
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