Procedural skills training during residency: Introduction of a procedure clinic to improve technical competencies

Jennifer Sy; Jeff Bloom; Nikolina Mizdrak; Azadeh Moaveni; Diana Toubassi

doi:10.46747/cfp.6904292

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RE: procedural skills
Robert S Russell

Published on: 19 April 2023

Published on: (19 April 2023)
Page navigation anchor for RE: procedural skills
RE: procedural skills
Robert S Russell, family doctor, Lakeside Medical Clinic Saskatoon
Interestingly I did a one year internship where there were no residents. We did 1/3 to 1/4 call, 8am-until 5-6 pm the next day. We covered ICU; did all the deliveries including suction and forceps under the guidance of specialists and FPs. We covered the ER department and after 11 pm there was no emergency doctor unless a consultant was called in by us. We did a lot of surgical assists, I did several appendectomies and some 40 tonsilectomies under the guidance of the specialists. We did lumbar punctures, circumcisions - which I refused to do once I graduated. We did all the cardiac arrests and the list goes on and on.

When I went out to rural practice I felt competent and sufficiently knowledgeable to provide appropriate care. Over the last 40 years the level of knowledge has easily tripled since I graduated and it is almost impossible to keep up with all the latest standards and knowledge. Thank goodness for the Internet. That being said, to provide appropriate care as a family physician is extremely time consuming, complex and the financial remuneration is inadequate.

I still believe that the hands on approach and degree of patient care that we were responsible for, although stressful at times, left me with the knowledge and confidence to do rural practice. Recent graduates appear not to have the same level of practical knowledge and experience that we received during our internship and final year in medicine which was all clinically based with significan...
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Interestingly I did a one year internship where there were no residents. We did 1/3 to 1/4 call, 8am-until 5-6 pm the next day. We covered ICU; did all the deliveries including suction and forceps under the guidance of specialists and FPs. We covered the ER department and after 11 pm there was no emergency doctor unless a consultant was called in by us. We did a lot of surgical assists, I did several appendectomies and some 40 tonsilectomies under the guidance of the specialists. We did lumbar punctures, circumcisions - which I refused to do once I graduated. We did all the cardiac arrests and the list goes on and on.

When I went out to rural practice I felt competent and sufficiently knowledgeable to provide appropriate care. Over the last 40 years the level of knowledge has easily tripled since I graduated and it is almost impossible to keep up with all the latest standards and knowledge. Thank goodness for the Internet. That being said, to provide appropriate care as a family physician is extremely time consuming, complex and the financial remuneration is inadequate.

I still believe that the hands on approach and degree of patient care that we were responsible for, although stressful at times, left me with the knowledge and confidence to do rural practice. Recent graduates appear not to have the same level of practical knowledge and experience that we received during our internship and final year in medicine which was all clinically based with significant clinical responsibilities.

I am not sure that a 3 year program in family medicine is necessary but if I were graduating today I would prefer to tailor my training to meet my personal interests, whether that be emergency medicine, obstetrics, dermatology, counselling etc.. We cannot know it all and in a rural practice it would be more appropriate and useful if each doctor had some subspecialty or interest to provide a broader level of expertise and utility to the community they are practicing in.

Sincerely

Dr Robert Russell MD, DTM&H, MHSc.
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Competing Interests: None declared.