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December 2017

The Evolution of Procedural Competency in Internal Medicine Training

Author Affiliations
  • 1Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
  • 2Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston
  • 3Division of Pulmonary and Critical Care, Department of Medicine, Massachusetts General Hospital, Boston
  • 4Division of Rheumatology, Department of Medicine, Massachusetts General Hospital, Boston
JAMA Intern Med. 2017;177(12):1713-1714. doi:10.1001/jamainternmed.2017.5014

The performance of procedures is as old as the medical profession itself. Indeed, perusing any volume of the Hippocratic Corpus reveals innovative methods for draining fluid or pus from body cavities. Millennia later, sampling fluid from the abdomen, the pleural space, the spinal canal, and joint spaces remains fundamentally important in the practice of medicine, and for decades these procedures have been largely under the purview of general internists. More recently, however, the profession has undergone a quiet but certain shift: internal medicine residents1 and practicing internists2 are becoming less comfortable with common bedside procedures.

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