The resident/fellow position is a physician in training who provides patient care and participates in an educational program commensurate with the individual physician’s level of advancement and competence. A resident/fellow physician’s responsibilities include patient care activities within the scope of their clinical privileges commensurate with their level of training, attendance at clinical rounds and seminars, timely completion of medical records, and other responsibilities as assigned or as required of all medical staff. Under the supervision of attending physicians, general responsibilities of the resident/fellow physician may include:
- Initial and ongoing assessment of patient’s medical, physical, and psychosocial status
- Perform history and physical
- Develop assessment and treatment plan
- Perform rounds
- Record progress notes
- Order tests, examinations, medications, and therapies
- Arrange for discharge and aftercare
- Write/dictate admission notes, progress notes, procedure notes, and discharge summaries
- Provide patient education and counseling covering health status, test results, disease processes, and discharge planning
- Perform procedures
- Assist in surgery
Residents/fellows participate in clinical medicine under the watchful eye of supervising teaching faculty and include:
- participation in safe and effective compassionate patient care;
- developing an understanding of ethical, socioeconomic, and medical/legal issues that affect graduate medical education, and how to apply cost effective measures in the provision of patient care;
- participation in the educational activities of the program as appropriate assumption of responsibility for teaching and supervising other residents/fellows and students and participation in institutional orientation and education programs and other activities involving the clinical staff;
- participation in institutional committees and councils to which the residents/fellows physician is invited to attend or are appointed;
- performance of these duties in accordance with the established practices, procedures, and policies of the institution and those of its programs, clinical departments, and other institutions to which the residents/fellows are assigned.
The resident/fellow physician is both a learner and a provider of medical care. The resident/fellow physician is involved in caring for patients under the supervision of more experienced physicians. As their training progresses, resident/fellow physicians are expected to gain competence and require less supervision progressing from on-site and contemporaneous supervision to more indirect and periodic
supervision.
Because resident/fellow physicians are given progressive responsibility for the care of a patient, it is the program’s responsibility to determine when a physician’s ability to provide care to patients without a supervisor or act in a teaching capacity. These are based on formative and summative evaluations of the resident’s/fellow’s clinical care, judgment, knowledge, and technical skill.
Ultimately, it is the decision of the teaching faculty with direct responsibility of the resident/fellow as to which activities the residents/fellows will be allowed to perform within the context of the assigned levels of responsibility. The overriding consideration must be the safe and effective care of the patient.
Twice a year, the program director will provide the resident/fellow physician performance ratings in the form of semi-annual evaluations in all of the six competencies. Resident/fellow physicians are apprised of their strengths and weaknesses at this time. At the completion of the program requirements, the residency/fellowship program director has the responsibility to determine and to document in writing that the resident/fellow physician possesses the skills necessary to practice at the level commensurate with their training.