Overall Principles


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Overall Principles

  1. 1. EXPECTATIONS FOR ATTENDING RADIOLOGISTS Graduated & Progressive Responsibilities for Residents Beth Israel Deaconess Medical Center Department of Radiology Revised 10/12/04 Overall Principles 1. The attending radiologist has the ultimate responsibility for all diagnostic and clinical decisions and implementation of those decisions for patients on the Radiology services. 2. The attending radiologist is responsible for the supervision of all medical care carried out by Radiology residents and other trainees working on the Radiology service 3. Attending radiologists supervising the house staff are available at all times throughout the year for guidance and supervision, regardless of specialty assignment or rotation. There is no barrier preventing discussion of clinical matters (and direct supervision when necessary) at any time. Such discussion and supervision are not only available they are encouraged. The attending physician is to make clear to each trainee that it is only failure to seek guidance that will be considered problematic. 4. Attending radiologists are expected to behave in a professional manner at all times in regard to trainee supervision. 5. All faculty members are expected to have received education in the signs and consequences of fatigue and sleep deprivation. Credentialing • Attending Radiologists at BIDMC are appointed through BIDMC medical staff office. • Attending Radiologists at BIDMC are expected to submit appropriate documentation for re-credentialing as requested by the medical staff office in a timely fashion. • Attending Radiologists are expected to comply with all bylaws and policies of the Medical Center.
  2. 2. • Attending Radiologists must have a full medical license issued by the Board of Registration in Medicine, and to renew and maintain licensure at all times. Specific Responsibilities: 1. The attending radiologist discusses, reviews, and participates in the review of each case in conjunction with the residents. 2. The attending radiologist is responsible to sign off on all radiology reports. 3. When the attending physician is `'off call" or signs out, that attending is expected to clearly indicate to the trainee that they are delegating coverage to another radiologist. The attending is responsible to clearly communicate to the chief resident, trainee and/ or the page operator who is the covering physician. 4. It is the responsibility of the attending radiologist to make sure the trainee knows how to call for help or advice at all times. Radiology attending staff supervision is available at all times. If a trainee has any difficulty contacting an attending physician they should call the program director, director of the clinical service, or department chairman. 5. The radiology attending directly supervises all procedures performed by residents. Resident physicians All residents are given the policies of the hospital, GME office and the department. It is expected that residents will work within the medical center policies. Radiology residents have completed a minimum of a one-year internship prior to the radiology residency. All residents are expected be able to use the hospital computer and Internet to research patient data and disease processes. In addition they must be able to use POE for ordering medications and investigations, use the PACS to view Xrays and the BIDMC Careweb system to look up pertinent patient data. They need to be able to dictate reports depending on the service to which they are assigned.
  3. 3. Students Resident and faculty members have responsibility for teaching and supervising medical students on the service. No clinical work (including diagnostic evaluation) is performed by medical students without supervision Graduated Responsibilities The attending physician is responsible to ascertain the level of training of a resident. It is expected that trainees will assume increased patient care responsibilities according to the level of training and experience. Progression in the radiology program is contingent on demonstrated competence. The program evaluates individual residents on a regular basis. Faculty schedules are structured to provide residents with continuous supervision and consultation. Residents rotate through the subspecialties services during assigned blocks of the residency. Lines of responsibility: Junior Resident (PGY 2 & 3) Senior Resident (PGY 4 or 5) Chief Resident (PGY5) Attending Staff Program Director Department Chair Trainees rotate through the following specialty rotations: Ultrasound CT scan Fluoroscopy Vascular and interventional MRI Breast Imaging Nuclear Medicine Thoracic radiology Progressive Responsibility 1. The Radiology attending physicians have the responsibility to assure that the Radiology house officers carry out clinical duties in a competent manner. Problems are reported to the program director and chairman, who will make changes in assignment or in residency training as appropriate. 2. All first year Radiology residents (PGY-2) must have successfully completed an internship. This provides the skills necessary to carry out the duties
  4. 4. of a first year Radiology. 3. Using evaluation reports from the attending physicians on resident performance during each rotation the program director and department chairman determine whether the resident is ready to take on the responsibilities of the next year. Requirements for Co signatures and Documentation It is expected that an attending radiologist will be present during all interventions or procedures performed by residents. Requirements for Co signatures and Documentation Attending radiologists are expected to sign off on all radiological reports. Schedules and coverage On call schedules for attending physicians shall provide for 24-hour supervision 7 days per week. This may be immediately available or adequate supervision from a reasonable distance within adequate time. There is a clear chain of command in the event of emergency. Evaluation Attendings are expected to provide feedback to the Program Director about the resident performance during the period of supervision. Residents are expected to submit evaluations on the attending staff and rotations.