This residency program will carry out the assessment of resident performance throughout training, will keep a permanent record of such assessments and will use the results of the assessments to improve resident performance.  The evaluations will be used to determine if the resident has met the skills required for promotion to the next level of training. The evaluations will be kept in a secure record accessible to the resident at any time.

Monthly Attending Evaluation of the resident:

• Patient Care
• Medical Knowledge
• Practice-based Learning and Improvement
• Interpersonal and Communication Skills
• Professionalism
• System-based Practice

Peer Evaluations:

• Professional Conduct
• Patient Care
• Medical Knowledge
• Interpersonal Communication

Mini-Cex:

• Will be done on each resident: 4 times during internship and twice during second year of residency

Skills Day:

A yearly skills day will be held to evaluate:

• Central Line Placement
• Airway management
• Paracentesis
• Thoracentesis
• Spinal Tap
• Laboratory Interpretation; UA, CXR, EKG, ABG, electrolytes, blood smears, liver function tests

Internal Medicine Clinic Evaluations - will assess, in addition to skills listed above

• Patient Care
• Medical Knowledge
• Practice-based Learning and Improvement
• Interpersonal and Communication Skills
• Professionalism
• System-based Practice

360 Degree Evaluations - of residents, by nurses- twice a year:

• Patient Care
• Interpersonal Communication
• Professionalism

Patient Evaluations – twice a year

• Patient Care
• Interpersonal Communication
• Professionalism

In-Training Internal Medicine Exam:

Assesses knowledge (not to be used to determine promotion to next level of training.)

1. Close observation of the resident while performing:
   • History and Physical: Bedside teaching, Emergency room, Clinic
   • Choice of diagnostic studies: admitting attending, morning report, clinic, emergency room
   • Formulation of differential diagnosis or problem lists: admitting attending, teaching rounds, morning report, clinic, emergency room
   • Development of plans for short term and long term medical management: admitting attending, teaching rounds, morning report, emergency room, clinic
   • Communication of treatment plans: admitting attending, teaching rounds, clinic, emergency room
   • Invasive Procedures: ICU attending, emergency room attending
   • Discharge planning: admitting attending, emergency room, clinic
2. Faculty, peer and co-worker observation of residents humanistic qualities: admitting attending, resident team members, clinic, nurses observations
3. Chart auditing for quality and format: review of history and physicals, progress notes, discharge summaries, clinic notes
4. Procedure Recorder: document indications, complications and outcomes of procedures, supervising physician.
5. Observation of Resident Talks, Journal Club, Conference participation. 

1. Face-to-Face review of monthly evaluation by the attending with the resident.  Signatures required.
2. On line availability of all evaluations for the resident.
3. Internal Medicine Committee to Evaluate Clinical Competence (CECC) will review all resident evaluations quarterly.
4. Semiannual counseling of each resident by the Dr. Mark Feldman, Chairman of Internal Medicine and Program Director, regarding: resident knowledge, skills, and professional growth as assessed by the Internal Medicine CECC.

A resident will be recommended for promotion by the CECC when he/she demonstrates:

• Achievement of competencies defined in the “competencies to be achieved by R1,R2,R3” documents.
• Satisfactory or above on all evaluations or evidence of remediation if needed.
• Completion of resident’s conference presentation and journal club assignments.
• Completion of the In-training exam
• Completion of a research project within 3 years.