Feedback from our community preceptors has suggested that many physicians would appreciate some guidance in understanding the expectations of family medicine residents at different stages of their two-year residency.
There are widely differing expectations among preceptors of a resident's skills at the beginning of residency. There are also discrepancies in the degree of autonomy granted a resident at all stages of the program, with some preceptors allowing resident freedom to make decisions from the outset while others are more reluctant to grant resident autonomy.
The following pages outline more specifically what family medicine residents should be able to do, and what new skills you can expect them to achieve during the various stages of training. Not all residents will achieve the benchmarks at the same stage of training, but it helps us, as educators, to more accurately gauge the resident's progress.
In addition, information is included about your role/duties as preceptors throughout these stages.
The Direct Observation Policy is incorporated in this document. Please see formal policy document for further details.
Please Note: the following benchmarks apply to Rotation Based Residents ONLY.
Preceptor Responsibilities1. Complete the learning contract with resident. Input from both preceptor and resident is expected. 2. Establish your expectations re: professional conduct - clinic start time, dress code; expectations re: nursing home visits, in-patient responsibilities etc. 3. Early: observe complete history and physical until comfortable that resident shows appropriate and consistent skills. 4. Observe resident doing several pelvic exams. 5. Thereafter, observe at least a portion of a history or physical at least once per half-day clinic. a) Encourage specific goal setting by the resident for these observations b) Obtain the residents sense of the success in meeting the goals c) Provide detailed feedback d) Develop a specific plan for implementation +/- further specific observation 6. Remind patients that all resident decisions are reviewed with you. 7. Encourage residents to explain thinking process in arriving at their DDx ("What else did you consider?"). 8. Ask resident to make a commitment to the most likely diagnosis. 9. Emphasize SOAP format for record keeping including use of the assessment section to explore their thinking process. 10. Counter-sign all resident entries. 11. Encourage resident to read around cases. 12. Assign reading where necessary (i.e. give a learning prescription). 13. Stress a professional approach, appropriate boundary setting, and standards for inter-collegial communication. 14. Ensure formal feedback is given at mid-way point (verbal and/or written if resident is struggling) and end of rotation (verbal and written). |
Resident Abilities
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Responsibilities and Goals of Resident
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Please Note: the following benchmarks apply to Rotation Based Residents ONLY.
Preceptor Responsibilities1. Complete learning contract for 2nd half of year: preceptor and resident input. 2. Observe a portion of a resident history or physical twice per week using the principles outlined previously. 3. Discuss each case, but interactions briefer, more focussed. 4. Fine tune approach to complete medical exam. 5. Review record keeping with expectation of exemplary records. 6. Allow resident to increase role in decision-making. 7. Watch for knowledge gaps, encourage ongoing reading. 8. Discuss preventative medicine. 9. Probe for understanding and appreciation for psychosocial aspect of patient's illness experience. 10. Watch for the over-confident resident who over-estimates ability. 11. Preceptor should have a good sense of resident's ability. Concerns should be raised with resident and/or program director. |
Resident Abilities
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Responsibilities and Goals of Resident
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Please Note: the following benchmarks apply to Rotation Based Residents ONLY.
Preceptor Responsibilities1. Gradual relinquishing of teacher/learner role and 2. Allow increasing autonomy and less supervision as 3. Allow some decisions regarding patient care even if preceptor not in full agreement, so long as patient well-being is not compromised. 4. Maintain regular positive and negative feedback. 5. Keep time available for resident to discuss cases. 6. Ongoing regular chart review either case-by-case |
Resident Abilities
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Responsibilities and Goals of Resident
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Please Note: the following benchmarks apply to Rotation Based Residents ONLY.
Preceptor Responsibilities1. Comfortable in allowing resident to manage care of patient in office. 2. Ensure resident manages time effectively. 3. Observe resident history or physical exam once per month (i.e. one per every four clinics). 4. Comfortable with asking resident's advice on difficult cases. 5. Primary preceptor recommends resident to write CCFP exam. |
Resident Abilities
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Responsibilities and Goals of Resident
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Please Note: the following benchmarks apply to Rotation Based Residents ONLY.
Resident Abilities
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