Procedure skill competence and certification in internal medicine residency training

Background: Procedure skill training and competency certification are an important part of internal medicine residency training. Expert guidelines exist on the minimum number of procedures recommended to attain competence, but these have not been validated. Purpose: To study the validity of the American Board of Internal Medicine (ABIM) recommended procedure guidelines. Methods: We performed a retrospective review of all monthly procedure log sheets collected during residency training for the graduates of our internal medicine residency program. The number of procedure attempts and the length of time needed to be certified as competent in 13 different procedures were recorded and compared with ABIM guidelines. Results: There were 69 graduates with an average of 32.7 monthly procedure log sheets per resident. There was a wide variation in the number of attempts and time needed to attain competence in the measured procedures. Overall, our residents received their competency certification for each required procedure within 1 SD of the corresponding ABIM recommendation. Conclusions: Our study suggests that the ABIM recommended guidelines on procedure skill competence may be valid on the program level.