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Supervision Policy


RCRMC assumes full responsibility for the supervision of resident physicians in the Family Medicine Residency Program. This responsibility is delegated to the individual departments and fulfilled by the Attending Physician (Medical Staff) in various clinical departments.


 1.  Supervision in the Family Medicine Department

Supervision of Family Medicine Residents by Family Medicine faculty occurs in the inpatient service, during longitudinal obstetrical care, and in the Family Care Clinic.

a.    Inpatient

The Family Medicine attending physician on the service must see and examine every patient on the service daily, and supervise residents by reviewing orders and plan of care. All PGY1 residents must have on site supervision by a senior resident or attending physician for all clinical duties including ED admissions, and ward patients. The Family Medicine attending physician  provides on site and in person supervision for all procedures.

The following require automatic attending notification:

  • All patients who are pregnant and in labor.
  • All patients less than the age of 18.
  • All patients age 75 and over.
  • Patients admitted as direct transfers from other hospitals.
  • Any patient transferred to the ICU, NICU or PICU.
  • Death or an sugnificant change in respiratory, neuological or hemodynamic status, including cardiac arrest.
  • Medication errors requiring clinical intervention.
  • Any significant clinical problem that will require an invasive procedure or operation that was not anticipated and addressed with attending physician.


b.    Obstetrical Deliveries/Procedures

The Family Medicine attending physician provides on site and in person supervision for all patients in active labor through delivery.

c.    Family Care Clinic

During each session in FCC, a ratio of no less than 1:3 to attending:resident will be used for precepting and supervision of residents.  Residents will be assigned to work with a particular attending during their clinic session.

In the first six (6) months of residency, all PGY1 residents must precept each patient at the time of visit with the attending physician present in the exam room for key assessments of the patient. In the last six (6) months in the first year of residency and during PGY2 and PGY3 years, all patient visits and progress notes must be reviewed and co-signed by an attending physician "live" at the time of the patient visit.   All procedures performed by residents in clinic must be supervised on site and in person by an attending physician.

 

2.    Supervision (Various Specialty Departments)

a.    Inpatient

The level of supervision must be commensurate with the resident’s level of training and his / her individual level of clinical skills. All PGY1 residents must have on site / in person supervision by a senior resident or attending physician for all clinical duties, including ED admissions and ward patients.  On call schedules for faculty assures that supervision and / or consultation is readily available at all times to residents on assigned clinical duties.

For inpatient and ED procedures, all PGY1 residents will be supervised on site / in person by an attending physician.

b.    Outpatient Clinics

During all three (3) years of residency, all patient visits and progress notes must be reviewed and co-signed by an attending physician "live" at the time of the visit.

All procedures performed by residents in the clinic must be supervised on site and in person by an attending physician.