How many of each procedures do you have to do in order to be board certified in internal medicine? I know a lot of co-residents (myself included) who haven't been logging procedures. Some items i've seen on our list, but unclear if they're required.

-arthrocentesis
-NG tube
-Pulmonary artery catheter
-IV line
-Venous lab draw
-I&D
-a-line
-LP
-Rectal
-Paracentesis
-Breast exam
-Pelvic/Gyn exam
-ABG
-Thoracentesis
-Central line (any differentiation between IJ, SC, and Fem?)

this is a great question
You know, we were told to fill out these procedure logs when I was a resident a couple of years ago, but I honestly don't know that I ever got "enough" of some procedures, or at least "enough" of them logged, and aside from occasional emails to all residents from the PD's secretary, I'm not sure anyone checks up on this. I think for central lines it's 5? I can't remember for LP and some others. Just ask the PD if you are concerned. My impression is perhaps nobody outside the program checks this?

ABIM does not specify a minimum number of procedures to demonstrate competency; however, to assure adequate knowledge and understanding of the common procedures in internal medicine, each resident should be an active participant for each procedure five or more times.

abim requirements (http://www.abim.org/certification/policies/imss/im.aspx)

you're not abim certified (board certified/bc) until you've taken and passed the abim.

you're eligible (board eligible/be) to sit for the abim once you've successfully completed residency.

by successfully completing residency, your program director attests to the fact that you have met and passed the minimum requirements for each of your residency years.

the link provided by orientedtoself is what you need.

Note on that link that the only procedures you have to be competent at now are drawing blood, ABG, peripheral IV, PAP smear, and ACLS. All the rest are "know when to do, interpret, and consent" but not actually do the procedure.

Does this mean I'm going to have to muscle in on a gyne clinic during my last month of residency and perform five pap smears before I can graduate? And I've done probably two dozen central lines but maybe only a couple peripheral IVs. Are these for real?

Does this mean I'm going to have to muscle in on a gyne clinic during my last month of residency and perform five pap smears before I can graduate? And I've done probably two dozen central lines but maybe only a couple peripheral IVs. Are these for real?

Ask your PD. My program assumed competence in IV's if you were signed off on lines. Same with ABGs and A-lines. We were required to have done the required number of Paps.

Does this mean I'm going to have to muscle in on a gyne clinic during my last month of residency and perform five pap smears before I can graduate? And I've done probably two dozen central lines but maybe only a couple peripheral IVs. Are these for real?

you haven't done a single pap smear in clinic?

if you went to a reasonably busy gyn clinic, you could probably knock out 5 paps in a full day of clinic.

you haven't done a single pap smear in clinic?

I have a VA clinic and have never seen a female patient within those walls. This somewhat limits one's pap opportunities.

I have a VA clinic and have never seen a female patient within those walls. This somewhat limits one's pap opportunities.

Having a VA clinic with only male residents is not allowed under current IM RRC rules. This is not new -- rules were changed in 1997. Your continuity experience -- meaning patients you see for the full three years of your residency -- must have 25% females. Block rotations in women's health clinics are not allowed. (Note -- new proposed rules which *MIGHT* be approved to start in 2009 totally change these rules yet again)

Having a VA clinic with only male residents is not allowed under current IM RRC rules. This is not new -- rules were changed in 1997. Your continuity experience -- meaning patients you see for the full three years of your residency -- must have 25% females. Block rotations in women's health clinics are not allowed. (Note -- new proposed rules which *MIGHT* be approved to start in 2009 totally change these rules yet again)
Are VA clinics essentially outlawed, then? Because I find it difficult to believe that any VA clinic is achieving 25% female patients.

Are VA clinics essentially outlawed, then? Because I find it difficult to believe that any VA clinic is achieving 25% female patients.

The Durham VA has Thursday in all ORs reserved for females only - and is fully filled every single Thursday.

When there's a referral center (which there is in every "district" or "zone" or however it is broken down), there's quite a volume of female patients.

The Durham VA has Thursday in all ORs reserved for females only - and is fully filled every single Thursday.

When there's a referral center (which there is in every "district" or "zone" or however it is broken down), there's quite a volume of female patients.
For any specialized care, I believe this. You might travel a couple hundred miles to get to the nearest tertiary VA for an operation or a cath or whatever. You are far less likely to make a lengthy trip for your pap, which you'll just get done in town somewhere. I see a fair number of female patients in the VA in other specialized contexts, but you don't get referred to a tertiary VA for primary care. I just see dudes who happen to live in this part of town.