Influence of residency training on procedures performed by South Carolina family medicine graduates.

Background And Objectives: Guidelines regarding procedure training in family medicine residencies are nonspecific. This study describes procedure practices of South Carolina family medicine residency graduates.

Methods: Of 1,416 surveys mailed to graduates of South Carolina Area Health Education Consortium (SC AHEC) family medicine residency programs, 144 were undeliverable. A total of 717 respondents (response rate 56.4%) were stratified by community size and year of graduation. Percentage performing 18 procedures (from a list developed by SC AHEC program directors) and stating lack of training affected their procedural practice was compared using chi square tests. Logistic regressions evaluating procedure performance included year of graduation, community size, region of country, and gender as independent variables.

Results: Joint aspiration/injection (81%), skin biopsy (81%), and Intensive Care Unit (ICU) care (48%) were the most common procedures. Physicians in smaller communities were more likely to perform joint aspiration/injection, skin biopsy, ICU care, and respirator management while recent graduates were more likely to perform exercise stress testing, ICU care, and respirator management. Lack of training was a common reason not to perform esophagogastroduodenoscopy, colonoscopy, nasopharyngoscopy, and vasectomy.

Conclusions: Increasing performance of exercise stress testing and ICU care by recent graduates and reported lack of training for several outpatient procedures may reflect evolving roles for family physicians. New residency training modalities may improve training for these roles.