B38-01 Time Out! Assessing Bedside Procedural Experience Among Internal Medicine Residents at a Large Academic Program

Abstract Rationale Procedural training in Internal Medicine (IM) residency has evolved significantly since 2008, driven by changes in the American Board of Internal Medicine (ABIM) procedural requirements, Accreditation Council for Graduate Medical Education (ACGME) common program requirements, and changing patient-care paradigms. As a result, there is a perception of declining experience and competency in performing bedside procedures, with potential downstream ramifications for pulmonary and critical care medicine (PCCM) fellowships. However, little is known about the scope of this problem across IM residency programs. We aimed to evaluate IM resident procedural exposure, perceived competence, and impact on patient care and future career success within a single, large academic residency. Methods We surveyed 169 IM residents (PGY1 n = 61, PGY2 n = 55, PGY3 n = 53) at a large US academic medical center (April-June 2025), focusing on exposure to commonly performed bedside procedures (arterial line, central venous catheter CVC, nasogastric tube placement, lumbar puncture LP, paracentesis, and thoracentesis) and perceived importance of procedural exposure for future career success. Additional data was gathered on the perceived impact of procedural exposure on patient care. Summary statistics were used to analyze the Likert-scale responses. Based on our hypothesis that perceptions about procedural training were related to future specialty, we stratified responses based on future career (i.e. procedurally-focused subspecialty cardiology, gastroenterology, or PCCM or not). Results A total of 47 residents completed the survey (response rate 28%), spanning post-graduate years (PGY1 n = 18, PGY2 n = 20, PGY3 n = 9). Of respondents, 68% (n = 32) were pursuing a procedurally-focused subspecialty. Ninety-one percent (n = 29) of those pursuing a procedurally-focused subspecialty and 33% (n = 5) of those not pursuing a procedurally-focused subspecialty agreed or strongly agreed that procedural exposure during IM residency would be important for future career success. The majority of all respondents disagreed or strongly disagreed that they had adequate opportunity to perform arterial lines (66% n = 31), CVCs (68% n = 32), LPs (94% n = 44), and thoracenteses (77%. n = 36). Respondents felt procedural exposure was limited by both diminished volume of procedures as well as the need for senior learners to gain procedural experience. Of respondents, 62% perceived clinical situations where patient care was negatively impacted due to lack of residents available to perform/supervise a given procedure. Conclusions Within a single IM residency, most residents reported inadequate exposure to commonly performed bedside procedures, despite a high perceived importance for future career success. This lack of procedural training and exposure during IM residency may have significant ramifications for PCCM fellowship programs. This abstract is funded by: None