• Steven J Durning, Lannie J Cation, and Jeffrey L Jackson.
• Department of Medicine (NEP), Uniformed Services University, Bethesda, MD 20814, USA. sdurning@usuhs.mil
• J Gen Intern Med. 2007 Mar 1; 22 (3): 357-61.

BackgroundAcquisition of competence in performing a variety of procedures is essential during Internal Medicine (IM) residency training.PurposesDetermine the rate of procedural complications by IM residents; determine whether there was a correlation between having 1 or more complications and institutional procedural certification status or attending ratings of resident procedural skill competence on the American Board of Internal Medicine (ABIM) monthly evaluation form (ABIM-MEF). Assess if an association exists between procedural complications and in-training examination and ABIM board certification scores.MethodsWe retrospectively reviewed all procedure log sheets, procedural certification status, ABIM-MEF procedural skills ratings, in-training exam and certifying examination (ABIM-CE) scores from the period 1990-1999 for IM residency program graduates from a training program.ResultsAmong 69 graduates, 2,212 monthly procedure log sheets and 2,475 ABIM-MEFs were reviewed. The overall complication rate was 2.3/1,000 procedures (95% CI: 1.4-3.1/1,000 procedure). With the exception of procedural certification status as judged by institutional faculty, there was no association between our resident measurements and procedural complications.ConclusionsOur findings support the need for a resident procedural competence certification system based on direct observation. Our data support the ABIM's action to remove resident procedural competence from the monthly ABIM-MEF ratings.

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