First year residency: how much clinical skills are required?

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Ven0m

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I'm an US IMG about to graduate with 0 hands on clinical experience (I have never placed a chest tube, central line, taken blood or anything). I am wondering, are brand new residents supposed to already know how to do these things? I am competent enough to pass the USMLE exams, and if I complete some US clinical experience programs, and match into a residency, will this be a good enough foundation to start learning on the job? How much clinical skills are residents already expected to know the first day on the job?

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Depends on what field you are in. If you are going into psych, for example, none of those skills will matter.

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I'm interested in internal medicine.
 
I have not seen any IM docs performing chest tube, central line, etc. unless they specialize in critical care/pulm. I don't know of any US grads who are comfortable doing such procedures fresh out of med school.

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I'm an US IMG about to graduate with 0 hands on clinical experience (I have never placed a chest tube, central line, taken blood or anything). I am wondering, are brand new residents supposed to already know how to do these things? I am competent enough to pass the USMLE exams, and if I complete some US clinical experience programs, and match into a residency, will this be a good enough foundation to start learning on the job? How much clinical skills are residents already expected to know the first day on the job?
You need to know how to take a history and perform a physical exam.

Coming up with a rudimentary assessment/plan is helpful as well.

Everything else? You'll learn.
 
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I have not seen any IM docs performing chest tube, central line, etc. unless they specialize in critical care/pulm. I don't know of any US grads who are comfortable doing such procedures fresh out of med school.

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Lots of IM docs do. Most don't do them in practice. A fresh PGY1 wouldn't be expected to do any of them.
 
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FYI, there's a difference between '0 clinical experience' and no procedure skills experience. Talking to patients is clinical experience. I wouldn't trust anyone from your school if you didn't have any clinical experience at graduation.
 
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Some experience doing a basic blood draw would be helpful
Thank you. I'm just trying to figure out what sorts of "clinical things" I should be emphasizing my practice on when I do get a chance to learn before applying to residency (eg, one poster mentioned history taking and physical exam); I'll add blood draws to my list.
 
unless you are doing residency in NYC, you won't be doing blood draws as an intern/resident.

I didn't train in NYC but drew blood during residency quite a bit. If you end up at a place with a hospital with a mostly underserved (read: underfunded) community, there's a good possibility you'll have to do it yourself if you want it done in a timely manner.
 
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You need to know how to take a history and perform a physical exam.

Coming up with a rudimentary assessment/plan is helpful as well.

Everything else? You'll learn.

Honestly. learn this HARDCORE. You need to be able to know what's pertinent and what's not and how to do things PROPERLY. Otherwise, you end up missing things that will either make you do a lot more work and the hospital pay a lot more money OR kill the patient.
 
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Honestly. learn this HARDCORE. You need to be able to know what's pertinent and what's not and how to do things PROPERLY. Otherwise, you end up missing things that will either make you do a lot more work and the hospital pay a lot more money OR kill the patient.
I didn't learn any of this during rotations due to the language barrier, just very basic things like taking history and "coming up with differentials". Are there any resources/places that I should seek out for this?
 
To what degree are the skills you guys are talking about (history, physical exam, choosing tests, etc) emphasized on the step 2 CS? In other words, if I can get a good score on both step 2 ck/cs, would I still need to actively seek out more training before I apply for residency?
 
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