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guidelines for invasive procedures by students?

Discussion in 'Medical Students - MD' started by tc, Sep 12, 2001.

  1. tc

    tc Member 10+ Year Member

    May 27, 2000
    Dallas, Texas
    I was surprised to find that we have no written policy or formal training requirements for lumbar punctures and comparably risky procedures. Basically, fresh 3rd year students can do LPs on any patient as long as the resident allows.

    The issue came up regarding a student who was ordered by a resident to do an LP on an uncooperative pediatric patient with suspected meningitis. The student had seen two LPs, but never done one. (The student refused. No, it wasn't me.)

    Does your school have a written policy, training requirements or restrictions on procedures performed by students? Are 3rd year students allowed to do heart transplants if the surgeon allows? (Sorry - just taking the argument to a logical extreme.)

    Surely there is some formal policy at most schools. Yes?

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  3. AJM

    AJM SDN Moderator Moderator Emeritus 7+ Year Member

    Jun 25, 2001
    The only written policy at my school that I was able to find is as follows:

    I think that the policy varies state to state according to state law. But I guess as long as the med student has "proper supervision" (the details of which is open to debate), that they theoretically can perform open heart surgery. Although it would really never go that far... ;)
  4. mj

    mj Senior Member 10+ Year Member

    Feb 13, 2000
    so if the student did it and something went wrong, who would own the liability?

  5. Whisker Barrel Cortex

    Whisker Barrel Cortex 1K Member 10+ Year Member

    Aug 10, 2001
    The student that refused should obviously go into a non procedure oriented specialty. After watching two LPs, the student should have read about the procedure and been prepared to do one. Everyone must do their "first" of a procedure. With the proper guidance, there should be no problem.

    If you are afraid to do a procedure or refuse to do one, it shows that you do not have the drive to read about how to do them and your residents will never offer another LP, thoracentesis, etc. to you. YOU WILL MISS OUT BECAUSE OF YOUR FEAR. Buck up and try a procedure.

    I know you were just asking about a written procedure, but your "example" is what I am talking about. By the way, liability in medical education is generally in the hands of the attending physician. The resident or student cannot be sued but their staff MD can be.
  6. CVPA

    CVPA Senior Member 10+ Year Member

    Oct 7, 2000
    Sorry, I disagree. I think it is foolish to have a 3rd medical student do their first LP on a Peds patient. I have done LPs in the past and let me tell you, it can be challenging enough on an adult, let alone a squirming, non-compliant child. Where I trained as a PA, procedures were first done on adults, then Peds. IMHO, thats how it should usually go. The "See one, Do one, Teach one" mentality is archaic & wreckless, at best.

    Finally, I don't think any real conclusions about this individual can be made, especially an MS-III who is still green and new to medicine. We have no idea what was going through that person's mind at the time. At least they had the guts to stand up for what they believed was the right thing.

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