Law and Public Policy

Medical students must not perform any procedures unless it is under the

direct, in-person, supervision of a PGY-2 or above.  On the Internal

Medicine service, medical students can apply to the program director to

receive written permission to draw blood or start IVs on their own after

they have been observed and supervised performing these procedures

successfully by a PGY-2 or above on 8 occasions each.

New York State Department of Health (and our Hospital) requires that

residents and students not perform any procedures on their own until they

have been given written privileges by the program director.

For a student or resident to be given written privileges by the program

director, a PGY-2 or above must certify that s/he has directly

supervised the performance of the procedure and that the student or

resident performing the procedure has demonstrated:

1.  Knowledge of the indications and contraindications for the

    performance of the procedure.

2.  Knowledge of the potential risks of the procedure and the

    ability to explain these to the patient in terms that the

    patient can understand.

3.  The technical ability to perform the procedure in an appropriate,

    safe and aseptic manner, with minimal discomfort to the patient.
4.  The ability to perform the procedure in a fashion that avoids
    risk to the student or resident performing the procedure and

    avoids risk to those assisting (e.g., wears shield to protect eyes

    and mucous membranes from splashes, wears gloves, uses devices that

    minimize chances of needle stick, appropriately discards all fluids

    and “sharps”).

5.  Ability to deal with (and report) potential complications.

6.  Ability to appropriately document the procedure in the hospital

    record, including informed consent when indicated.

The PGY-2 or above providing such certification must themselves have

been given the privilege of a supervisory role.  They can then indicate

that you have satisfactorily demonstrated the above mentioned traits

by printing their name, the date, and signing where indicated on the

"procedure form".  Procedure forms are available in the program

director's office.  Once signed by the supervising resident, the form

should be turned in to the program director’s office. 

Medical students and residents in training may not perform any procedures

on their own until they have actually received written privileges

from the program director. 

If a student or resident physician in training performs a procedure

(or supervises a procedure) outside of the scope of their individual

written privilege, this will be reported to the program director and will

result in a triggering of a review and discipline protocol.  For

medical students, this will include notification of their school

and termination of their clinical rotations at our hospital.