Supervisory Responsibility for Patient Care

  1. All physicians (including resident physicians) are authorized and expected to do whatever is considered necessary to preserve life in the event of a life-threatening emergency.  In the event of a life-threatening emergency, resident physicians should take whatever action deemed necessary to preserve life while someone else summons help from any available senior resident or faculty member.
  2. All patients cared for in the UAMS Surgery Residency Program are cared for under the direction of a designated faculty attending surgeon. The specific level of faculty supervision will vary depending on the level of training and skill of the resident, the complexity of the care rendered, and the wishes of the responsible attending surgeon. The level of supervision required for an individual procedure will be determined on an individual basis between the resident and the responsible faculty member unless a defined level of supervision is mandated by institutional or service policy.
  3. Significant patient caredecisions and events are to be discussed with the appropriate attending surgeon. If the responsibleattending surgeon is unavailable, contact the attending surgeon on call for the appropriate service or the attending surgeon on call for the day. Although residents are responsible for their individual actions and senior residents are responsible for the performance of their service, overall responsibility for patient care always rests with the attending surgeon.
  4. Authority for supervision may be delegated at the discretion of the attending surgeon to more senior surgical residents. In general, the senior resident assigned to the service will be in charge of the service and is expected to assume a leadership role.  Except in emergencies, the “chain-of-command” of junior resident – senior resident – attending surgeon should be followed regarding patient care decisions. Under some circumstances, junior residents may work directly with attending surgeons. In this instance, the junior resident must keep the senior resident informed of significant events regarding the service. Individual resident assignments are to be made by the senior resident at the start of each rotation. Although residents are often intimately involved in the care of surgical patients, all patient care activities are ultimately the responsibility of the designated attending surgeon.
  5. Attending surgeons are responsible for ensuring that coverage is available for their patients by another attending surgeon during their absence. In the event that an attending surgeon is not immediately available, residents should contact the covering surgeon through the Department of Surgery answering service (501-686-7874). If contact with an attending surgeon is necessary and the designated attending or covering attending is not immediately available, contact the attending surgeon on call for the hospital in which the patient is being cared.