PGY3 Responsibilities

[Rampant]

---

Members don't see this ad.

I just wanted to see if some senior residents could give some perspective regarding the variation in reponsibilities in different programs across the country as a senior resident.

Do you primary supervise interns, medical students, other residents, acting as an intermediary between lower levels and the attendings? Or do you still see patients primarily and present to attendings directly. Some combination of the two? Do interns present directly to attendings at your program or do they go through intermediaries?

I have seen some variation and this has sparked some debate so I am interested in various practices. There is a somewhat of competiting interest between more lower level interactions with attendings vs progressive responsibility of upper levels so it would be interesting to see the trend.

Appreciate any responses.

 

[southerndoc]

Yale PGY-3's spend about 60% of time doing critical care shifts and 40% supervising junior residents. PGY-4's spend 60% of time supervising and 40% in a critical care area. PGY-4's have very little overnight shifts as they are responsible for running full traumas during the day. So the vast majority of your shifts are day shifts as a 4.

 

[NateintheED]

Depends on the shift here. Our PGY-3's primarily supervise interns/R2's/rotators/students. Our attendings do like interaction with all of these folks as well, so I don't see all the lower levels' patients. The way I work is I try to see everyone who may actually be sick. We see quite a bit of pretty low acuity stuff as well. Especially for the R2's, I often don't have too much to add/teach about these patients, so I have them go directly to attendings to facilitate throughput. On night shifts when our acuity is generally much lower, I'll have the lower levels take a lot more to the attending and try and see some of the quickies myself as well. I also tell all the lower levels that even for low acuity patients, I am happy to see anyone they're not sure or have a question about.

 

[Station51]

Seniors (PGY-3) at my program see patients and supervise interns/rotators/students. However, interns still have a good portion of their shifts assigned to a module where there is no senior and present directly to attendings. PGY-2's always present directly to an attending.

 

[WakeDoc]

The way its supposed to work here (Wake Forest) is PGY2 sees all the sick patients and traumas, the PGY3 trys to see the overflow stuff and manage flow of the ED. In reality, due to our acuity level and rapid turnover, PGY3 ends up seeing the sick patient's the PGY2 can not. For example, we often have more then 1 or 2 traumas at the same time, so they see the ones the PGY2 doesn't get to.

I think all of our Sr's would prefer more experience in running the dept, however it just can not be done due to our volume. We are trying to get more upper levels in the dept to allow this role to be assumed more frequently by the PGY3s.

 

[EM Kane]

At Orlando, the senior resident (PGY 3) staffs the trauma bay and sees the majority of the critical patients. They are available to the other residents for questions or assistance, but all residents staff directly to attendings. There are dedicated teaching shifts for PGY3s, where the med student present to the teaching resident, get polished up, then the student presents to the attending. The teaching resident supervises the student procedures and makes sure they get lunch.

 

[Rampant]

Appreciate continuing responses to this topic as seniors are able to comment. The data and diversity of setups is interesting and gives some perspective.