POLICY AND PROCEDURE: Advancement of Residents (Promotion and Graduation)
[Internal Medicine Categorical Residency Program/Primary Care and Medicine-Pediatrics]

          Advancement from Resident Year 1 (R1) to Resident Year 2 (R2)

• Successfully completed R1 rotations.  The Clinical Competence Committee will be responsible for reviewing any unsatisfactory evaluations and for determination of any necessary remediation.
• Passed the Mini Clinical Evaluation Exercises as determined by assigned Department of Medicine Faculty.
• Certified in ACLS.
• Competent to supervise R1 residents and medical students per Department of Medicine faculty evaluation.
• Able to perform resident duties with limited independence per Department of Medicine faculty evaluation.
• Successfully performed all entry-level procedures, with documentation on file in the Department of Medicine.
• Competent to provide Internal Medicine consultations with Moderate supervision.
• Has demonstrated sufficient progress in the components of clinical competence that he/she is capable of functioning as a team leader.  Specifically, the resident has the necessary skills in data gathering, medical knowledge, clinical insight, and critical thinking to assume a team leadership role.  He/she is demonstrating elements of practice-based learning and system-based learning in clinical encounters.
• Attendance at required conferences (70% minimum).
• Completion of medical records.
• Conformity to SVCMC and St. Vincent's Manhattan By-laws and Rules and Regulations.

Advancement from R2 to R3

• Successfully completed R2 rotations.  The Clinical Competence Committee will be responsible forreviewing any unsatisfactory evaluations and for determination of any necessary remediation.
• Has taken USMLE Step 3 examination.
• Competent to supervise R1 and R2 residents and medical students per Department of Medicine faculty evaluation.
• Competent to provide Internal Medicine consultations with minimal supervision.
• Seeks appropriate consultation when indicated.
• Able to perform resident duties with minimal supervision per Department of Medicine faculty evaluation.  The resident is capable of making independent decisions based on previous clinical experiences.  He/she has the ability to recognize and manage 'new' clinical problems (scenarios not previously encountered) skillfully.

Advancement from R3 to R4 (Medicine-Pediatrics)

• Successful completion of assigned rotations.
• Attendance at required conferences.
• Completion of medical records.
• Conformity to all By-Laws, Policies, Procedures and Regulations of SVCMC St. Vincent's Manhattan.

Completion of Training

• Successfully completed R3/R4 rotations.  The Evaluation and Promotion Committee will be responsible for reviewing any unsatisfactory evaluations and for determination of any necessary remediation.
• Able to perform independently in the practice of general internal medicine per Department of Medicine faculty evaluation.
• Successfully performed all required procedures, with documentation on file in the Department of Medicine.
• Has the sufficient medical knowledge base, problem-solving skills, and clinical judgment that enable him/her to provide satisfactory patient care.
• Successfully completed scholarly activity to the satisfaction of the faculty.
• Has demonstrated practice-based and system-based learning in clinical encounters.
• Passed Step 3 successfully.

At every level of advancement and at the time of completion of training, the resident must demonstrate the following:

• Interpersonal and communication skills are satisfactory or superior, as documented by evaluators in inpatient and ambulatory settings.  Works well with patients, fellow residents, faculty, consultants, ancillary staff and other members of the health care team in a manner that fosters mutual respect and facilitates the effective handling of patient care issues as demonstrated by satisfactory staff and faculty professional behavior evaluations.  Any disciplinary actions plans as a result of unprofessional behavior must have been successfully completed.
• Absence of impaired function due to mental or emotional illness, personality disorder, or substance abuse.  Any disciplinary actions or treatment programs implemented per the WSU policies on impaired function must have been successfully completed and reinstatement approved by the Internal Medicine Program Director.
• Must have been in compliance with all the Rules and Regulations of and Contractual Arrangements with Saint Vincent Catholic Medical Centers - St. Vincent's Hospital Manhattan.