Family medicine residency program director expectations of procedural skills of medical school graduates.

BACKGROUND AND OBJECTIVES Mismatch between program directors' expectations of medical school graduates and the experience of students in medical school has important implications for patient safety and medical education. We sought to define family medicine residency program directors' expectations of medical school graduates to independently perform various procedural skills and medical school graduates' self-reported competence to perform those skills at residency outset. METHODS In July of 2011, a paper-based survey was distributed nationwide by mail to 441 family medicine residency program directors and 3,287 medical school graduates enrolled as postgraduate year 1 (PGY-1) residents in family medicine residency programs. Program director expectation of independent performance and recent medical school graduate self-reported ability to independently perform each of 40 procedures was assessed. RESULTS Surveys were completed and returned from 186 program directors (response rate 42%) and 681 medical school graduates (response rate 21%). At least 66% of program directors expected interns to enter residency able to independently perform 15 of 40 procedures. More than 80% of new interns reported they were able to independently perform five of the 15 procedures expected by program directors. CONCLUSIONS Incongruity exists between program director expectations and intern self-reported ability to perform common procedures. Both patient safety and medical education may be jeopardized by a mismatch of expectation and experience. Assessment of medical students prior to medical school graduation or at the start of residency training may help detect procedural skill gaps and protect patient safety.