Resident Roles & Responsibilities
(last updated 2/2007)

Roles and Responsibilities pertain to all levels of resident training unless otherwise indicated:

• Perform an appropriately directed and thorough clinical history of patients on their service.
• Perform an appropriately directed and thorough physical examination of patients.
• Assess the condition of patients on their service.
• Review laboratory data and results of other studies of patients on their service.
• Communicate clinical findings effectively to other interns, residents, fellows and attending physicians.
• Initiate management for the patient’s condition writing the appropriate orders in the patient’s chart having discussed the patient’s case with senior residents, fellows and attending physicians.
• Following up on results of therapeutic interventions and diagnostic studies.
• Documenting appropriately in the patient’s chart the initial History and Physical Exam, daily progress notes, event notes and procedure notes.
• Completion of forms related to patient care including facility transfer forms, death certificates and outpatient prescriptions.
• Pre-round on patients on the service prior to clinical rounds with the fellow and attending. Pre-rounding will include performing an appropriate clinical history, physical exam, reviewing laboratory and study results and developing an assessment of the patient’s condition and a diagnostic and therapeutic plan.
• Perform procedures as seen appropriate on patients (approved procedures listed separately).

• Attend weekly continuity clinic where you evaluate and follow up on patients.
• Rotate through multiple medical and surgical sub-specialty clinics on the Jefferson campus and satellite outpatient offices (including the VA).
• Carry out an appropriate clinical history and physical examination for patients presenting to the outpatient office.
• Assess severity of illness for patients presenting to the outpatient office.
• Review laboratory data and results of other studies for patients presenting to the outpatient office.
• Follow up on results of therapeutic interventions and diagnostic studies.
• Develop an appropriate diagnostic and management plan under the supervision of an attending physician.
• Communicate clinical findings effectively to supervising attending physicians and consulting physicians.
• Document initial history and physical exam form and progress notes.
• Perform outpatient procedures including but not limited to pelvic and breast examinations (approved procedures listed separately).
  

• Supervise Interns in the ICU.
• Supervise/Perform Procedures (approved procedures listed separately).
• Patient Management- responsible for patients in the ICU as well as ectopic patients in other ICUs.
• Evaluate patients to determine if they meet ICU criteria for admission.
• Admissions- complete H&P, admission orders, review with attending/fellow.
• Daily rounds with attending and fellows.
• Facilitate patient transfer to the ICU from outside hospital or within Jefferson.
• Write transfer note when patient is discharged from the ICU.

• Supervise the on-call intern with patient care and procedures.
• Work up new admissions to his/her unit with the on-call intern, including H&P, admission orders, and review with attending/fellow.
• Respond to codes.
• Serve on the Rapid Response Team.
• Assist Night Float or MARs as necessary.
• Cover ectopic ICU/CCU patients overnight.
• Facilitate patient admission and discharges from the ICU/CCU.

• Perform all duties managing patients in the inpatient setting including the ICU (same as Jefferson inpatient responsibilities).
• Assist in transferring patients to outside hospitals for diagnostic and therapeutic interventions not available at the VA.
• Triage patients in the emergency department and discuss disposition with attending assigned to the ED (PGY 3 only).
• Attend one ambulatory rotation (PGY 2 and 3 only).

• Perform all duties managing patients in the inpatient setting (same as Jefferson inpatient responsibilities).
• Only manage patients on the teaching services.
• Evaluate and admit patients to the ICU and CCU.
• Perform procedures as seen appropriate on patients (approved procedures listed separately).

• Understand and apply the basic principles of triage.
• Assess severity of illness for patients presenting to the emergency department with appropriate supervision.
• Carry out an appropriate clinical history and physical examination for patients presenting to the Emergency Department (ED)..
• Develop an appropriate diagnostic and management plan under the supervision of the Emergency Department attending physician.
• Emphasis on management is given to stabilization of the acutely ill patient.
• Communicate clinical findings effectively to other interns, residents, fellows and attending physicians.
• Present patients for admission.
• Document initial history and physical exam form and progress notes.
• Perform procedures specific to the ED under the supervision of ED attending or senior resident.

• Cover outpatient calls from the Jefferson Hospital Ambulatory Practice (JHAP), triage and make recommendations.
• Communicate all JHAP calls covered with the JHAP directors.
• Triage patients in the ED presented by the ED staff for admission or consultation.
• Assign patients to the appropriate medical service.
• Triage patients directly admitted to the hospital and assign to the appropriate medical service.
• Admit patients overnight to the medical services to be redistributed in the morning.
• Serve as the supervising resident to the interns and night float (as House Chief).
• Serve as backup to the Rapid Response Team.
• Serve as backup to the unit residents.

• Perform an appropriately directed and thorough clinical history and physical examination of hospitalized patients on their service requiring attention.
• Learn about patients through evening signout and then communicate events taken place overnight to the primary team during morning signout.
• Assess the condition of patients signed out from the primary teams.
• Review laboratory data and results of other studies of patients signed out.
• Communicate clinical findings effectively to other interns, residents, fellows and attending physicians.
• Initiate management for the patient’s condition writing the appropriate orders in the patient’s chart having discussed the patient’s case with senior residents, fellows and attending physicians.
• Follow up on results of therapeutic interventions and diagnostic studies.
• Document appropriately in the patient’s chart progress notes, event notes and procedure notes.
• Perform bedside procedures as needed.

• Carry the service pager and write daily progress notes on up to 12 patients.
• Admit only up to 5 patients per call day.
• Teach and supervise 3rd year medical students.
• Write off-service notes at the end of an inpatient rotation.
• Attend dedicated intern morning reports and resident noon lectures.
• Attend grand rounds and morbidity and mortality conferences.
• Evaluate re-distributed patients first thing in the morning on weekends.
• Prepare an intern case presentation.
• Participate in the gynecological and prostate review course (categorical only).
• Complete the Teaching Residents to Teach course (categorical only).

• Supervise intern during daily workday.
• Supervise on-call intern with admissions/procedures/patient care.
• Admit up to 8 patients including H&P, orders, and review with attending/fellow,
• Evaluate re-distributed patients first thing in the morning.
• Participate in daily rounds with attending/fellow.
• Dictate patients discharged from his/her primary service (Jefferson only).
• Serve on the code team and back up to the Rapid Response Team.
• Supervise 3rd /4th year medical students.
• Write daily progress notes if inpatient service is in excess of 12 patients.
• Attend morning report and noon conference daily on weekdays.
• Attend grand rounds and morbidity and mortality conferences.
• Prepare each of the following presentations at least once throughout residency:  inpatient case presentation, ambulatory case presentation, evidence based medicine, journal club, senior seminar, and ICU/CCU case presentations.
• Complete the ECG and Chest X-ray competency evaluations.

• Participate in outpatient and inpatient medical subspecialty electives.
• Provide backup to inpatient services for residents who are unable to attend to their duties due to illness or personal issues (Pull system)
• Participate in assigned research projects.

• Perform medical consultation and Jefferson Antithrombotic Service (JATS) consultations.
• Cover general medicine overflow inpatients.

• Evaluate geriatric patients in the outpatient and nursing home settings.

• Take care of inpatients in the Bone Marrow Transplant Unit.
• Perform any procedures necessary in the Unit.
• Provide thorough signout to the moonlighter.

PROCEDURES performed by PGY1s:

• Use of handwashing and sterile aspectic techniques
• Arterial Blood Gas sampling
• Nasogatric Tube insertion
• Peripheral IV access
• Rectal and Prostate Examination
• Breast Examination
• Any procedure that a PGY2 or PGY3 does under proper supervision

PROCEDURES performed by PGY2s and PGY3s include the procedures by PGY1s and the following:

• Perform bedside ultrasound guided procedure techniques
• Lumbar Puncture
• Central Venous Line Access
• Paracentesis
• Thoracentesis
• Arthrocentesis
• Arterial Line Access