Procedural skills training in the internal medicine residency.

To determine whether there was agreement on a core of procedural skills that all internal medicine residents should be able to perform, faculty members and residents at the University of Pennsylvania and the University of Nebraska were surveyed regarding 72 procedures. Nineteen procedures were indicated by 90 percent or more of the respondents as those that should be learned by the graduates. In response to a second survey, many senior residents said they did not feel competent to perform these 19 procedures, and many did not recall that their performance on procedures had been evaluated. Thus, despite any regional or institutional influences, there was agreement on a core of procedural skills that should be required of all physicians completing the general internal medicine residency. It is important that training programs assess whether or not the procedures they consider essential are being mastered by their residents.