Resident Privileges, Procedure Supervision Guidelines and Escalation of Care Criteria

Residents are physicians with an M.D. or D.O. degree and, at a minimum, a Virginia temporary license and are often fully licensed to practice.  They enter with basic medical knowledge and continue to add special skills and knowledge that will allow them to become fully certified in a medical or surgical specialty.  The resident utilizes his or her superiors as consultants as independence is developed and the need for direct supervision declines.  They become competent to make judgments of increasing complexity and to perform procedures of increasing difficulty throughout their residency education.  The outcome of this philosophy of education produces a physician who has had responsibility for self-learning, for teaching, for independent patient care, and for obtaining consultation when appropriate.

Supervision of residents exists in several forms which may be described as follows:

  • Direct Supervision – The supervising physician is physically present with the trainee and patient (CPR VI.D.3.a).  This level of supervision corresponds with supervision by "Faculty Present" or "Senior Resident or Fellow Present."
  • Indirect Supervision with Direct Supervision immediately available – The supervising physician is physically within the hospital or other site of patient care, and is immediately available to provide Direct Supervision (CPR VI.D.3.b).(1).  This level of supervision corresponds with supervision by "Faculty in Area" or "Senior Resident or Fellow in Area."
  • Indirect Supervision with Direct Supervision available – The supervising physician is not physically present within the hospital or other site of patient care, but is immediately available by means of telephonic and/or electronic modalities, and is available to provide direct supervision within 30 minutes after contact (CPR VI.D.3.b).  This level of supervision corresponds with supervision by "Faculty by Phone" or "Senior Resident or Fellow by Phone."
  • Oversight – The supervising physician is available to provide review of procedures/encounters with feedback provided after care is delivered (CPR VI.D.3.c).