Are procedures important for internist?

[laserbeam]

I will work as an IM intern in a busy community hospital. There are plenty of scut work to do, such as ABG, blood draw, IV push, etc. We can also be certified for certain procedures, such as arterial line placement. Are procedures important after residency? At this time, I only want to practice general internal medicine, either as a hospitalist, or traditional IM. I want to budget my time wisely and learn the most important/useful medical knowledge.

---

Members don't see this ad.

 

[Trifling Jester]

I will work as an IM intern in a busy community hospital. There are plenty of scut work to do, such as ABG, blood draw, IV push, etc. We can also be certified for certain procedures, such as arterial line placement. Are procedures important after residency? At this time, I only want to practice general internal medicine, either as a hospitalist, or traditional IM. I want to budget my time wisely and learn the most important/useful medical knowledge.

Depends on where you go and how your contract is set up. If your contract is going to pay you for procedures like central lines etc then you may or may not do them depending on how proficient you are at them. If your contract doesn't pay then you'll consult someone else to do it for sure. I can't imagine any scenario where you'd get paid to do an ABG or blood draw, so for those types of procedures you wouldn't be doing them.

 

[laserbeam]

Depends on where you go and how your contract is set up. If your contract is going to pay you for procedures like central lines etc then you may or may not do them depending on how proficient you are at them. If your contract doesn't pay then you'll consult someone else to do it for sure. I can't imagine any scenario where you'd get paid to do an ABG or blood draw, so for those types of procedures you wouldn't be doing them.

Thanks for the reply. It looks like being able to do procedures gives me more job options, but not a necessity.

 

[angel80]

I'm a primary care internist. After finishing residency, I went and did additional courses in outpatient Orthopedic and Derm procedures. It's nice because I don't have to refer those out, plus the pay is much better than just office visits. It takes 5 min to do a joint injection, and it pays more than some of the higher level office visits. I also really enjoy doing procedures and they are a nice way to break up the day so that I don't feel like I'm doing the same thing over and over again.

 

[45408]

If you're a hospitalist, and your patient isn't doing well, so you ship them off to the ICU, who's going to put in the art line?

You might work at a place with an open MICU, and you might be the one who should be putting in an a-line. I think anyone who will ever be the admitting physician to an ICU should be able to put in a central line and an a-line. Just my opinion.

 

[laserbeam]

I'm a primary care internist. After finishing residency, I went and did additional courses in outpatient Orthopedic and Derm procedures. It's nice because I don't have to refer those out, plus the pay is much better than just office visits. It takes 5 min to do a joint injection, and it pays more than some of the higher level office visits. I also really enjoy doing procedures and they are a nice way to break up the day so that I don't feel like I'm doing the same thing over and over again.

I like the idea. No need for formal fellowship training.

 

[laserbeam]

If you're a hospitalist, and your patient isn't doing well, so you ship them off to the ICU, who's going to put in the art line?

You might work at a place with an open MICU, and you might be the one who should be putting in an a-line. I think anyone who will ever be the admitting physician to an ICU should be able to put in a central line and an a-line. Just my opinion.

It is nice to be versatile. However I do not feel that three years' IM training gives enough time and opportunity to perform procedures. Maybe some post-residency training will help?

 

[Instatewaiter]

It is nice to be versatile. However I do not feel that three years' IM training gives enough time and opportunity to perform procedures. Maybe some post-residency training will help?

you really feel you won't have the ability to put in an A line and central line? If so, perhaps you should change residencies

 

[laserbeam]

you really feel you won't have the ability to put in an A line and central line? If so, perhaps you should change residencies

One week into residency, I already did quite several ABGs. I figure that I am a trainable material, if circumstances really call for a high priority on procedures. If not, I'd rather focus on things that I am more good at. Change residency? No, no, no, I love IM to death.

 

[jdh71]

It is nice to be versatile. However I do not feel that three years' IM training gives enough time and opportunity to perform procedures. Maybe some post-residency training will help?

bull****

 

[gutonc]

I guess it depends on the procedures you're talking about.

LPs, thoras, paras, central lines and a-lines (+/- tubes depending on your program)? If you don't get enough of those to at least have a go at it then you probably need to do residency again at a different program.

Skin biopsies, suturing, MSK stuff (joint aspirations/injections, etc), botox, hair plugs? Yeah...you're probably not going to get enough of those to feel comfortable.

 

[sacrament]

One week into residency, I already did quite several ABGs. I figure that I am a trainable material, if circumstances really call for a high priority on procedures. If not, I'd rather focus on things that I am more good at. Change residency? No, no, no, I love IM to death.

I don't think he meant change specialty, he meant change residency program. An IM resident should feel very comfortable with central line and art lines by the end of their residency, or at least comfortable enough to achieve these in the majority of patients. Three years is definitely enough time for this, considering that (in my opinion) the learning curve for these particular procedures starts to flatten out after a dozen or so.