Graded Responsibility

For the PGY2 - 4 years the administrative chief residents will make daily assignments for clinical responsibilities. While on Research block an individual resident is free from clinical responsibilities except to take evening and weekend call and a half day clinic. These responsibilities are divided between resident continuity outpatient clinics, emergency room consults, in-house patient consults and operating room time. Each resident will adhere to the clinic and surgical schedule of the service to which they are assigned. Each resident will have at least a  half-day of resident continuity clinic per week. The resident on the pediatrics rotations will have an additional full day of dedicated pediatric resident clinic. The residents in the PGY2-4 years will also have one-two half days in faculty clinic new patient assessment, an average of four half days of operating room assignment, and two half days of emergency room coverage, in-house consults, or academic time. The PGY5 residents will spend the majority of their week in the operating room with participation in attending clinic as the schedule allows. The chief residents share responsibility in organizing the resident allocation for any one day. The chief residents also spend one half day per week in continuity clinic. These teams make joint daily working - teaching rounds in the mornings and then disperse to cover the OR, or the clinic/ward/ER activities according to service assignment.

Each postgraduate year is a progressive, graded assumption of responsibility. The progressive level of responsibility is based upon the knowledge, preparation and technical skills of the individual resident. The expectations of progressive gains in competency and capability are delineated in the goals and objectives for each rotation. Each resident is evaluated on their attainment of the goals and objectives by the faculty on the subspecialty service through which they are rotating. In general, the department expects that junior residents will be actively engaged in learning the basics of patient care and increasing their medical knowledge base. During this time, the junior residents will need more faculty oversight and will not be capable of any substantial independent decision making or procedural execution. Since all clinical rotations involve a tremendous interaction with faculty and senior residents, the junior residents steadily gain confidence and capability in the clinical arena. As residents progress through training toward the chief year, the rotational goals and objectives guide the expectation of greater capacity to demonstrate independent decision making and patient care skills.