What procedures do you master as a derm intern?

[InvitroDerm]

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So I just finished reading "Intern" and have a question for residents going into specialties, specifically derm. One procedure he had to do (he's an internal medicine resident) involved sticking the lung (I can't really remember) but as a result of his inexperience, the lung collapsed. He then said that he felt bad that someone better trained didn't do it but he "had to learn." So, in derm, how many procedures (like central lines) with a steep learning curve do you do/master in the prelim year even though you may never do them again?

 

[asmallchild]

Prelim years are completed in medicine or surgery, not derm. And I don't know too many derm residents routinely doing central lines or thoracenteses (unless you go to a very special derm program 🙂 )

 

[oracle07]

I personally avoided lines and other invasive IM procedures whenever possible. Like you said, I did not see the point in causing a patient pain when someone more experienced or someone who needed the experience could do it.

Of course, in emergent situations you may be asked to do it. However, if a co-intern of mine needed the experience, they seemed to always be willing to do it... and thankful for the opportunity to add to their log...

I had the option to become certified in different IM procedures my intern year, but I elected not to. I didn't log procedures because quite honestly, I didn't want to be certified because I didn't feel comfortable doing procedures without supervision...

Thankfully I never had any major complications with the procedures I did do, and that was another reason I didn't want to be labeled as "certified" -- to me being certified means you know how to handle the complications!

 

[reno911]

There are really two variables that will determine what procedures you'll master as an intern

1. opportunity - patients you see, program you're in
2. your motiviation to do them (other interns that are actually going in to the field you're doing your prelim in will always be eager to do extra procedures)

So there's no great answer to this. After my internship I could confidently do a thoracentesis, paracentesis, LP and put in various lines. I really tried to learn these things because I like procedures. However, now I cannot do any of these things now and I would have been just fine if I never learned them. So learning exactly how to do them was not really that "useful" to me.