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==Levels of Supervision== |
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==Levels of Supervision== |
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*VI.D.3. Levels of Supervision. To ensure oversight of resident supervision and graded authority and responsibility, the program must use the following classification of supervision: |
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*One of the big changes in the guidelines is more strict guidelines for supervision, in particular for supervision of first year residents. |
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** VI.D.3.a) Direct Supervision – the supervising physician is physically present with the resident and patient. |
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*Specialty specifics definitions have been posted on the ACGME website that define levels of supervision. Pathology, both residency and specialized fellowships requirements are listed on page 27-33 of this document. |
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* http://www.acgme.org/acwebsite/dutyhours/Specialty-specific_DH_Definitions.pdf |
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* The following is from this document... |
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* Each PGY-1 resident must be '' directly (see definition of direct supervision below)''supervised during performance of at least 3 initial procedures in each |
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** Gross dissection of each surg path specimen by organ system |
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** FNA and interpretation |
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* Our program is thinking about going to a "checklist" system for new first years. It is up for debate how to handle for example 2nd or 3rd years who may have already done some of these things before. Do they need a checklist also? Do we "grandfather" them in? |
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* ''An upper level resident, pathology assistant or attending may supervise gross dissection of surg path specimens and/or autopsies'' |
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* ''Blood bank fellows, upper level residents or attending may directly supervise apheresis'' |
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'''''<u>Definitions (from the ACGME Guidelines and from the Speciality-Specific Guidelines)</u>''''' |
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* Upper levels are defined as |
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** PGY3 or PGY4 if a resident is combined AP/CP |
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** PGY2 or PGY3 if a resident is AP only or CP only |
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** It is still unclear to me if a PGY2 AP/CP ("intermediate level") can supervise a PGY1 |
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* VI.D.3. Levels of Supervision. To ensure oversight of resident supervision and graded authority and responsibility, the program must use the following classification of supervision: |
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** VI.D.3.a) Direct Supervision – the supervising physician is ''<u>'''physically present '''</u>''with the resident and patient. |
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** VI.D.3.b) Indirect Supervision: |
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** VI.D.3.b) Indirect Supervision: |
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*** VI.D.3.b).(1) with direct supervision immediately available – the supervising physician is physically within the hospital or other site of patient care, and is immediately available to provide Direct Supervision. |
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*** VI.D.3.b).(1) with direct supervision immediately available – the supervising physician is physically within the hospital or other site of patient care, and is immediately available to provide Direct Supervision. |
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*** VI.D.3.b).(2) with direct supervision available – the supervising physician is not physically present within the hospital or other site of patient care, but is immediately available by means of telephonic and/or electronic modalities, and is available to provide Direct Supervision. |
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*** VI.D.3.b).(2) with direct supervision available – the supervising physician is not physically present within the hospital or other site of patient care, but is immediately available by means of telephonic and/or electronic modalities, and is available to provide Direct Supervision. |
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* Specialty specifics definitions have been posted on the ACGME website that define levels of supervision. Pathology, both residency and specialized fellowships requirements are listed on page 27-33 of this document. |
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** http://www.acgme.org/acwebsite/dutyhours/Specialty-specific_DH_Definitions.pdf |
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** The following is from this document... |
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** Each PGY-1 resident must be directly supervised during performance of at least 3 initial procedures in each |
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*** Gross dissection of each surg path specimen by organ system |
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|
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*** FNA and interpretation |
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** Our program is thinking about going to a "checklist" system for new first years. It is up for debate how to handle for example 2nd or 3rd years who may have already done some of these things before. Do they need a checklist also? Do we "grandfather" them in? |
|
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** ''An upper level resident, pathology assistant or attending may supervise gross dissection of surg path specimens and/or autopsies'' |
|
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** ''Blood bank fellows, upper level residents or attending may directly supervise apheresis'' |
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** ''Upper levels are defined as '' |
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*** ''PGY3 or PGY4 if a resident is combined AP/CP '' |
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*** ''PGY2 or PGY3 if a resident is AP only or CP only '' |
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*** ''It is still unclear to me if a PGY2 AP/CP ("intermediate level") can supervise a PGY1 '' |
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==Duty Hours== |
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==Duty Hours== |