The JCAHO asks for PGY level-specific Housestaff job descriptions.  In the Department of Medicine, as required by the ACGME, each year of residency provides increasing levels of responsibility.   All residents report, through the Chain of Command, ultimately to the attending physician caring for the patient.  Residents are allowed to perform a History and Physical Examination, with the permission of the patient, while adhering to all appropriate chaparone regulations.  And residents are allowed to perform procedures, while adhering to all appropriate regulations regarding informed consent, under the general supervision of the attending physician caring for the patient, to the extent deliniated on the Procedure Form signed by their Program Director.  

The PGY-1:  Functions as primary physician for patients on any medicine rotation.  Develops an accurate description of the present illness in chronological sequence with appropriately complete information in past history, family history and social history, including Advance Directives and  Health Care Proxy.   Performs a complete physical examination, including Pap/Pelvic where appropriate. Uses laboratory and diagnostic studies appropriately.  Records data, including a list of current medications (Medex) in a problem oriented medical record and makes certain that all notes/orders are dated, timed, signed, and that there is a clearly printed/imprinted physician name as well as a beeper number.  Develops a complete and appropriate Problem List with an associated Assessment and Plan of diagnostic and therapeutic options, which are implemented only after agreed to by the attending physician of record.  Serves as an effective teacher for medical students.  Establishes effective positive relationships with the patient and family, other physicians, and members of the healthcare team.    Presents information accurately, concisely and in logical sequences, using meaningful terminology that is unambiguous. Knows how and from whom to seek assistance, when needed.  Knows how to contact the attending of record and does so regarding changes in patient status or to discuss management issues.  Observes patient rights, safety, confidentiality, and reports errors and adverse events via the Hospital reporting system.  .

The PGY-2:  Functions as the Medical Resident on the Medical Services, establishes positive relationships with the patient and family, other physicians and members of the health care team.  Keeps the attending of record informed of any significant changes in patient status.  Acquires the skills needed to care for patients in an Emergency Room setting.  Acquires the knowledge necessary to serve as a consultant and completes consultations in a timely fashion.  Presents a conference to the Department on a medically relevant topic.  Teaches students, interns, and other residents as appropriate.  Supervises  medical students and PGY-1s, and remains capable of performing all of the duties of a PGY 1 resident if the occasion arises.  Attends and participates in various assigned Hospital committees. 

The PGY-3:  Supervises students, PGY-1 and PGY-2 residents, and facilitates communication with patients, families, the attending physician and other members of the health care team.  Acquires theknowledge, skills, attitudes and behaviors necessary to serve as a consultant.  Serves as senior consultant in medicine for surgical and psychiatric patients.  Teaches students, interns and other residents. Actively participates in teaching conferences, including presenting a conference to the Department.  Capable of performing the duties of a PGY-1 or PGY-2 resident if called upon to do so.   Summarizes data from conferences, such as Grand Rounds, and presents this  to peers.   Analyses current literature and presents data a Journal Club meetings.  Completes an IRB approved clinical research project and presents such information to peers.   Participates in Community Service activities.