Resident Supervision
The Residency Supervision Area is designed to assist hospitals and clinics with the protocols outlined for specific duties residents and fellows can perform. These guidelines are determined by the faculty of the University of Tennessee Health Science Center. Any questions about certain procedures not listed should be addressed to the faculty and not decided by the resident or fellow.
A credentialed and privileged attending physician ultimately provides supervision or oversight of each resident's patient care activities. Direct supervision by a qualified attending physician is required in the OR/Delivery Room or for non-routine invasive procedures like Cardiac Cath, Endoscopy, and Interventional Radiology. The standards for resident supervision in patient care settings are described in GME Policy #410.
Bolton, William Matt - PGY - 3
Department of Radiology
Resident Supervision
PGY 2, 3, 4, or 5 Radiology
trainees can perform the procedures listed below with indirect supervision:
|
Radiology Residency Program |
PGY2 |
PGY3 |
PGY4 |
PGY5 |
|
Review and Preliminarily Read: |
|
|
|
|
|
Plain
films |
X |
X |
X |
X |
|
Fluoroscopic
exams |
X |
X |
X |
X |
|
CT |
X |
X |
X |
X |
|
Ultrasound |
X |
X |
X |
X |
|
MR |
X |
X |
X |
X |
|
Nuclear
medicine exams |
X |
X |
X |
X |
|
Consult on
technique and work-up methods using any of the modalities available to the
Dept. of Radiology |
X |
X |
X |
X |
|
Perform
fluoroscopic exams |
X |
X |
X |
X |
Radiology
program-specific Supervision Policy and Clinical Activities Addendum is
available below.
All
other procedures are performed under direct supervision of a faculty member.
The UT/Methodist Healthcare Diagnostic Radiology Residency follows the UTHSC institutional policy on Resident Supervision. Program- specific policy items are found below.
1. Supervision of Residents:
See addendum Specific Clinical Activities and Level of Supervision.
2. Procedure Competence: See
addendum Specific Clinical Activities and Level of Supervision.
3.
PGY1 resident supervision: The diagnostic radiology residency program
does not have PGY1 residents. The program starts at the PGY2 level; residents
on track to start the radiology residency program must complete an internship
year in another preliminary program, such as the Transitional Year program.
4.
Supervision guidelines for circumstances and events: The radiology
resident would contact her/his supervisor in the event of any of the following:
a.
Any significant complication from a radiology procedure
b.
Any case in which the resident does not feel qualified to make a decision
c.
Any situation in which patient care is compromised by the lack of a supervisor
5. Description of Resident
Clinical Responsibilities: See addendum Specific Clinical Activities and Level
of Supervision.
6.
Resident and Faculty Policy Awareness: Residents and faculty will be
educated on supervision policies and procedures (including the ACGME
requirement that residents and faculty members should inform patients of their
respective roles in each patient’s care) annually.
A copy of the policy will be kept on the residency’s private webpage.
The Full UT Policy is available here: http://www.uthsc.edu/GME/policies/supervision_pla2011.pdf
See
also Addendum to the Radiology Program Supervision Policy: Specific Clinical
Activities and Level of Supervision
Addendum to the Radiology Program Supervision Policy: Specific Clinical Activities and Level of Supervision
|
Clinical Activity |
Resident
Level |
Method of Instruction |
Instructor Level |
Supervision Level |
Certification
Requirements to Perform Activity without Direct Supervision |
Method to Confirm Competent to
Perform Procedure/Activity |
|
H&P |
PGY1+ |
Direct Clinical Instruction |
PGY2+ |
Indirect
after Instruction |
PGY1+ after Initial Instruction |
PGY Level
since all Radiology Residents are PGY2+ |
|
Informed Consent for NVIR
Procedures |
PGY1+ |
Direct Clinical Instruction |
PGY2+ |
Indirect
after Instruction |
PGY1+ after Initial Instruction |
PGY Level
since all Radiology Residents are PGY2+ |
|
Informed Consent for IR Procedures |
PGY1+ |
Direct Clinical Instruction |
PGY2+ |
Indirect
after Instruction |
PGY1+ after Initial Instruction |
PGY Level
since all Radiology Residents are PGY2+ |
|
Resuscitating Patients |
PGY1+ |
Direct Clinical Instruction |
PGY2+ |
Indirect
after Instruction |
PGY1+ after Initial Instruction |
PGY Level
since all Radiology Residents are PGY2+ |
|
Post-Procedural Examination of Vascular Access |
PGY2+ |
Direct Clinical
Instruction |
PGY3+ |
Indirect after Instruction |
PGY2+ after satisfactory
completion of Interventional Radiology rotation |
Satisfactory
completion of Interventional Radiology rotation |
|
Fouroscopy: |
|
|
|
|
|
|
|
Barium Enema |
PGY2+ |
Direct Clinical
Instruction |
PGY3+ |
Indirect after Instruction |
PGY2+ after
satisfactory completion of GI/ GU Radiology and Diagnostic Radiology
Rotations |
Satisfactory completion of GI/ GU Radiology and
Diagnostic Radiology Rotations |
|
Upper GI Series |
PGY2+ |
Direct Clinical
Instruction |
PGY3+ |
Indirect after Instruction |
PGY2+ after
satisfactory completion of GI/ GU Radiology and Diagnostic Radiology
Rotations |
Satisfactory completion of GI/ GU Radiology and
Diagnostic Radiology Rotations |
|
Small Bowel Follow-
Through |
PGY2+ |
Direct Clinical
Instruction |
PGY3+ |
Indirect after Instruction |
PGY2+ after
satisfactory completion of GI/ GU Radiology and Diagnostic Radiology
Rotations |
Satisfactory completion of GI/ GU Radiology and Diagnostic
Radiology Rotations |
|
Placement of NG Tube |
PGY2+ |
Direct Clinical
Instruction |
PGY3+ |
Indirect after Instruction |
PGY2+ after
satisfactory completion of GI/ GU Radiology and Diagnostic Radiology
Rotations |
Satisfactory completion of GI/ GU Radiology and
Diagnostic Radiology Rotations |
|
IVP |
PGY2+ |
Direct Clinical
Instruction |
PGY3+ |
Indirect after Instruction |
PGY2+ after
satisfactory completion of GI/ GU Radiology and Diagnostic Radiology
Rotations |
Satisfactory completion of GI/ GU Radiology and
Diagnostic Radiology Rotations |
|
Flouro-Guided
LP |
PGY2+ |
Direct Clinical
Instruction |
PGY3+ |
Indirect after Instruction |
PGY2+ after
satisfactory completion of GI/ GU Radiology and Diagnostic Radiology
Rotations |
Satisfactory completion of GI/ GU Radiology and
Diagnostic Radiology Rotations |
|
Shoulder
Anthrogram |
PGY2+ |
Direct Clinical
Instruction |
PGY3+ |
Indirect after Instruction |
PGY2+ after
satisfactory completion of GI/ GU Radiology and Diagnostic Radiology Rotations |
Satisfactory completion of GI/ GU Radiology and
Diagnostic Radiology Rotations |
|
Hip
Anthogram |
PGY2+ |
Direct Clinical
Instruction |
PGY3+ |
Indirect after Instruction |
PGY2+ after
satisfactory completion of GI/ GU Radiology and Diagnostic Radiology
Rotations |
Satisfactory completion of GI/ GU Radiology and
Diagnostic Radiology Rotations |
|
Herniagram |
PGY2+ |
Direct Clinical
Instruction |
PGY3+ |
Indirect after Instruction |
PGY2+ after
satisfactory completion of GI/ GU Radiology and Diagnostic Radiology
Rotations |
Satisfactory completion of GI/ GU Radiology and
Diagnostic Radiology Rotations |
|
Ultrasound: |
|
|
|
|
|
|
|
US-Guided
Thoracentesis |
PGY2+ |
Direct Clinical Instruction |
PGY3+ |
Indirect
after Instruction |
PGY2+ after satisfactory completion of Ultrasound Rotation |
Satisfactory
completion of Ultrasound Rotation |
|
US-Guided
Paracentesis |
PGY2+ |
Direct Clinical Instruction |
PGY3+ |
Indirect
after Instruction |
PGY2+ after satisfactory completion of Ultrasound Rotation |
Satisfactory
completion of Ultrasound Rotation |
|
US-Guided
Thyroid Biopsy |
PGY2+ |
Direct Clinical Instruction |
PGY3+ |
Indirect
after Instruction |
PGY2+ after satisfactory completion of Ultrasound Rotation |
Satisfactory
completion of Ultrasound Rotation |
|
CT: |
|
|
|
|
|
|
|
CT-Guided Core Liver
Biopsy |
PGY2+ |
Direct Clinical
Instruction |
Attending Physician |
Indirect
Supervision with Direct Supervision Immediately Available (ie, attending in
hospital) |
PGY2+ after satisfactory
completion of Body Imaging and Non-Vascular Interventional Radiology
Rotations |
Satisfactory completion of
Body Imaging and Non- Vascular Interventional Radiology Rotations |
|
CT-Guided Abscess Drainage |
PGY2+ |
Direct Clinical
Instruction |
Attending Physician |
Indirect
Supervision with Direct Supervision Immediately Available (ie, attending in
hospital) |
PGY2+ after satisfactory
completion of Body Imaging and Non-Vascular Interventional Radiology Rotations |
Satisfactory completion of
Body Imaging and Non- Vascular Interventional Radiology Rotations |
|
CT-Guided Solid Organ Fine
Needle Aspiration |
PGY2+ |
Direct Clinical
Instruction |
Attending Physician |
Indirect Supervision
with Direct Supervision Immediately Available (ie, attending in hospital) |
PGY2+ after satisfactory
completion of Body Imaging and Non-Vascular Interventional Radiology
Rotations |
Satisfactory completion of
Body Imaging and Non- Vascular Interventional Radiology Rotations |
|
CT-Guided Solid Organ Core
Biopsy |
PGY2+ |
Direct Clinical
Instruction |
Attending Physician |
Indirect Supervision with Direct Supervision
Immediately Available (ie, attending in hospital) |
PGY2+ after satisfactory
completion of Body Imaging and Non-Vascular Interventional Radiology
Rotations |
Satisfactory completion of
Body Imaging and Non- Vascular Interventional Radiology Rotations |
|
Image-Guided Central Venous Access |
PGY2+ |
Direct Clinical
Instruction |
PGY3+ |
Indirect after Instruction |
PGY2+ after satisfactory
completion of Interventional Radiology rotation |
Satisfactory
completion of Interventional Radiology rotation |
|
|
|
|
|
Indirect |
|
|
|
|
|
|
|
Supervision |
|
|
|
|
|
|
|
with Direct |
|
|
|
|
|
|
|
Supervision |
|
|
|
|
|
|
|
Available (ie, |
|
|
|
|
|
|
|
attending a |
|
|
|
|
|
Direct Clinical |
Attending |
phone call |
|
|
|
Chest x-ray |
PGY3+ |
Instruction |
Physician |
away) |
Satisfactory completion of the PGY2 year |
PGY Level |
|
|
|
|
|
Indirect |
|
|
|
|
|
|
|
Supervision |
|
|
|
|
|
|
|
with Direct |
|
|
|
|
|
|
|
Supervision |
|
|
|
|
|
|
|
Available (ie, |
|
|
|
|
|
|
|
attending a |
|
|
|
|
|
Direct Clinical |
Attending |
phone call |
|
|
|
CT abd/pel |
PGY3+ |
Instruction |
Physician |
away) |
Satisfactory completion of the PGY2 year |
PGY Level |
|
|
|
|
|
Indirect |
|
|
|
|
|
|
|
Supervision |
|
|
|
|
|
|
|
with Direct |
|
|
|
|
|
|
|
Supervision |
|
|
|
|
|
|
|
Available (ie, |
|
|
|
|
|
|
|
attending a |
|
|
|
|
|
Direct Clinical |
Attending |
phone call |
|
|
|
CTA/MRA |
PGY3+ |
Instruction |
Physician |
away) |
Satisfactory completion of the PGY2 year |
PGY Level |
|
Mammography |
PGY2+ |
Direct Clinical Instruction |
Attending
Physician |
Direct |
N/A |
PGY Level |
|
|
|
|
|
Indirect |
|
|
|
|
|
|
|
Supervision |
|
|
|
|
|
|
|
with Direct |
|
|
|
|
|
|
|
Supervision |
|
|
|
|
|
|
|
Available (ie, |
|
|
|
|
|
|
|
attending a |
|
|
|
|
|
Direct Clinical |
Attending |
phone call |
|
|
|
MRI body |
PGY3+ |
Instruction |
Physician |
away) |
Satisfactory completion of the PGY2 year |
PGY Level |
|
|
|
|
|
Indirect |
|
|
|
|
|
|
|
Supervision |
|
|
|
|
|
|
|
with Direct |
|
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|
|
Supervision |
|
|
|
|
|
|
|
Available (ie, |
|
|
|
|
|
|
|
attending a |
|
|
|
|
|
Direct Clinical |
Attending |
phone call |
|
|
|
MRI brain |
PGY3+ |
Instruction |
Physician |
away) |
Satisfactory completion of the PGY2 year |
PGY Level |
|
|
|
|
|
Indirect |
|
|
|
|
|
|
|
Supervision |
|
|
|
|
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|
|
with Direct |
|
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|
Supervision |
|
|
|
|
|
|
|
Available (ie, |
|
|
|
|
|
|
|
attending a |
|
|
|
|
|
Direct Clinical |
Attending |
phone call |
|
|
|
MRI knee |
PGY3+ |
Instruction |
Physician |
away) |
Satisfactory completion of the PGY2 year |
PGY Level |
|
|
|
|
|
Indirect |
|
|
|
|
|
|
|
Supervision |
|
|
|
|
|
|
|
with Direct |
|
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|
|
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|
|
Supervision |
|
|
|
|
|
|
|
Available (ie, |
|
|
|
|
|
|
|
attending a |
|
|
|
|
|
Direct Clinical |
Attending |
phone call |
|
|
|
MRI spine |
PGY3+ |
Instruction |
Physician |
away) |
Satisfactory completion of the PGY2 year |
PGY Level |
|
|
|
|
|
Indirect |
|
|
|
|
|
|
|
Supervision |
|
|
|
|
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|
|
with Direct |
|
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|
Supervision |
|
|
|
|
|
|
|
Available (ie, |
|
|
|
|
|
|
|
attending a |
|
|
|
|
|
Direct Clinical |
Attending |
phone call |
|
|
|
PET |
PGY3+ |
Instruction |
Physician |
away) |
Satisfactory completion of the PGY2 year |
PGY Level |
|
|
|
|
|
Indirect |
|
|
|
|
|
|
|
Supervision |
|
|
|
|
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|
|
with Direct |
|
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|
Supervision |
|
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|
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|
|
Available (ie, |
|
|
|
|
|
|
|
attending a |
|
|
|
|
|
Direct Clinical |
Attending |
phone call |
|
|
|
US abd/pel |
PGY3+ |
Instruction |
Physician |
away) |
Satisfactory completion of the PGY2 year |
PGY Level |