Progressive Authority / Supervision Policy

Family Medicine Reno Residents

Policy On Progressive Authority, Responsibility, Conditional Independence and Supervisory Role

Residents at all levels are monitored and evaluated to determine the proper level of responsibility and degree of supervision required. The following progression applies on all services that Family Medicine residents work on unless specifically stated otherwise. This includes Family Medicine, Internal Medicine, Surgery, Obstetrics, and Pediatrics. Residents are monitored and progressed in a step-wise manner as described below.

Monitoring and documentation of resident competency and supervisory abilities is achieved through a variety of methods.

  1. Residents are observed doing all procedures.
  2. Residents log their procedures using New Innovations.
  3. Residents are observed and evaluated by faculty as they teach and supervise junior residents and students.


All entering residents have taken and passed Step 1 and 2 USMLE, including the Clinical Skills exam, demonstrating competency (as determined by the USMLE) on both medical knowledge and patient interactions. Initially entering residents have DIRECT SUPERVISION for all patient interactions for the first six months. 

PGY1 residents may progress from direct to indirect supervision with direct supervision immediately available based on resident review by the  Clinical Competency Committee (CCC) after six months.


In order to progress to the PGY 2 level, residents must have attained the necessary skills listed and demonstrate the ability to work with indirect supervision with direct supervision available as determined by the CCC. 

PGY3 and PGY4

PGY3 and PGY4 Residents are progressing towards independent practice and therefore have continued progression in their conditional independence, authority, responsibility and supervisory role of learners.


04/10/2018 by Clinical Competency Committee (CCC)