Table 1.

Core Procedures for Family Medicine Residents

CAFM Procedure Cluster	CAFM Procedure Category	Procedure
Anesthesia	A0	Topical anesthesia. Local anesthesia/field block
	A1	Digital block
	A2	Peripheral nerve block (other than digital nerve)
Cardiovascular	A0	Arterial puncture
Eyes, ears, nose, throat	A0	Removal of foreign body from ear or nose
	A0	Cerumen disimpaction
	A0	Anterior nasal packing for epistaxis
	A0	Fluorescein examination of the eye without a slit lamp
	A0	Superficial conjunctival foreign body removal
	A2	Slit-lamp examination
	A2	Removal of superficial corneal foreign body
Gastrointestinal and colorectal	A0	Nasogastric tube
	A0	Fecal disimpaction. Digital rectal examination
	A1	Anoscopy
	A2	Paracentesis
	A2	Incision and drainage of perianal abscess
	A2	Excision of thrombosed external hemorrhoid
	A2	Remove perianal skin tags
Genitourinary	A0	Bladder catheterization
Musculoskeletal	A0	Simple closed reduction of subluxed joint without sedation (eg, nursemaid elbow)
	A1	Upper- and lower-extremity splints
	A1	Upper- and lower-extremity casts
	A1	Injection/aspiration of joint, bursa, ganglion cyst, tendon sheath, or trigger point
	A2	Reduction of shoulder dislocation
Pulmonary	A0	Hand-held spirometry
Pulmonary	A2	Thoracentesis
Skin	A0	Remove corn/callus
	A0	Drain subungual hematoma
	A0	Laceration repair with tissue glue or skin staples
	A1	Removal of skin tags
	A1	Biopsies (punch, shave), including vulvar biopsy
	A1	Excisional biopsy
	A1	Destruction of skin lesion (including warts) using cryosurgery, RF/electrocautery, chemical ablation, or intralesional injection
	A1	Remove ingrown nail or full toenail
	A1	Incision and drainage of abscess, including paronychia
	A1	Simple laceration repair with sutures
	A2	Fine-needle aspiration of cyst (including breast)
	A2	Needle biopsy of solid mass
Women’s health	A0	Pap smear collection
	A1	Bartholin cyst management (Word catheter)
	A1	Remove cervical polyp
	A1	Endometrial biopsy
	A2	Cervical dilation
	A2	Colposcopy
	A2	Cervical cryotherapy
	A2	Uterine aspiration/dilation and curettage

A0 = simple procedures that family medicine residency graduates should be able to perform independently on the basis of skills acquired in medical school or residency; A1 = all residents must be able to perform these procedures independently by graduation; A2 = procedures for which all family medicine residencies are expected to offer training; CAFM = Council of Academic Family Medicine; Pap smear = Papanicolaou test; RF = radiofrequency.
Note: Outpatient only; laboratory, neurologic (lumbar puncture), and ultrasonography clusters excluded. Pediatric and reproductive health procedures excluded.
Adapted from: CAFM Consensus Statement for Procedural Training in Family Medicine Residency.³