Supervisor Responsibilities

DEPARTMENT OF RHEUMATOLOGY

SUPERVISION POLICY

 The Department of Rheumatology adheres to the ACGME rules regarding faculty supervision. As the fellows develop their skills over the course of two years of training, they are progressively given increased responsibility with appropriate level of supervision by the faculty.

All faculty members must remain current on their credentials and privileges in all three hospital setting (Upstate Medical University, Crouse Irving Memorial Hospital, Veterans Administration of Syracuse). Information about faculty credentials and privileges can be attained via request to thru Upstate Medical Staff Service Office.

Faculty members have the discretion to designate to the fellows, residents, and medical students varying levels of responsibility for patent care and the needs of the patients. In the patient care setting, it is the supervising faculty who is ultimately in-charge. The fellows must inform the patients of their role as fellow in training during their encounters.

Faculty members provide the following levels of supervision based upon the fellow’s competency in training (Defined by the ACGME):

Direct Supervision: The supervising physician is physically present with the resident and patient

Indirect Supervision: With direct supervision immediately available, the supervising physician is physically present within the hospital or other site of patient care and is immediately available to provide Direct Supervision AND/OR With Direct Supervision available the supervising physicians is not physically present within the hospital or other site of patient care, but is immediately available by means of telephone and/or electronic modalities and is available to provide direct supervision after travel to the site of patient encounter.

Oversight: The supervising attending physician is always present during invasive procedures and personally examines each patient before diagnostic work-up is initiated or treatment decisions are made of recommended to other patient care teams. The attending physician routinely provides review of procedures/encounters after care is delivered.

In the clinical out-patient setting, the faculty preceptor has direct and indirect supervision of the fellow. When the patient first arrives the fellow will have indirect supervision from the faculty in attaining patient history and information. Then the precepting faculty member will have direct supervision and oversight of the fellow during the consultation and examination of the patient. All diagnostic testing and treatment plans prepared by the fellow will have oversight from the precepting faculty member.

In the clinical in-patient setting, the attending has both direct and indirect supervision of the fellows. All patients both new and follow-up care consult patients are discussed at least daily between the attending physician and the fellow on consult. Overtime as the fellow is determined to be more competent as shown thru their semi-annual milestone evaluations, the level of supervision goes from direct to indirect depending upon the patient load and the needs of patients. The attending is immediately available 24/7 if need be by the fellow either on-site or via phone. The fellow is advised to contact the attending for any questions they might have.

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