Trainee Position Description and Essential Functions

General Overview of the Resident Role 

A resident’s responsibilities include patient care responsibilities within the scope of their clinical privileges commensurate with level of training and other responsibilities required of all members of the medical staff. Under the supervision of attendings, general responsibilities of the resident may include: 

• Initial and ongoing assessment of patients’ medical, physical and psychosocial status 
• Performing history and physical examination 
• Developing assessment and treatment plan 
• Performing rounds 
• Recording documentation, including progress notes, admission notes, procedure notes and discharge summaries 
• Ordering tests, examinations, medications and therapies 
• Arranging for discharge, referral and after care. 
• Providing patient education and counseling about health status, test results, disease processes and transition of care planning 
• Performing procedures 
• Assisting in surgery 
• Teaching and evaluating junior learners, such as medical students 

UW GME Expectations for Professional Behavior 

• All residents must comply with the UW Medicine Policy on Professional Conduct and the UW Medicine Compliance Code of Conduct 
• ACGME Competencies in Professionalism, including fitness for duty (See ACGME Common Program Requirements) 
• All residents must comply with GME Policies, including the Resident and Fellow Position Appointment Agreement (RFPA) 

 

Essential Functions 

Essential functions are the fundamental job duties of the position that cannot be eliminated or substantially modified without changing the nature of the position.  

A job function may be considered essential for the following reasons: 

• The reason the position exists is to perform that function 
• Resident educational requirements and patient care responsibilities 
• A limited number of available residents can perform that function 
• Varies by program, rotation, year, risk pools, etc. 
• The function may be highly specialized so that the trainee in the position is hired for their expertise or ability to perform the particular function 
• Cannot easily hire more trainees, especially of a specific R level 
• The percentage of time spent on a function does not determine whether or not it is essential. 

Essential functions for GME residents must include consideration of: 

• ACGME program requirements 
• Specialty board requirements 
• UW program requirements 
• Unique to each UW training program and must consider: 
• Complexity of rotations/service requirements 
• Size of program 
• Structure and depth of risk pools 
• Please refer to the program’s Clinical Coverage Policy 
• Inclusive of the hospital system requirements: 
• Rotations dependent on residents’ service for patient care 
• Coverage options available 

A resident must perform the position’s essential job functions with or without an approved reasonable accommodation. Reasonable accommodation means modifying or adjusting practices, procedures, policies, job duties, or the work or application environment so that a qualified individual with a disability can still perform a position’s essential functions. Approved reasonable accommodations are determined via an interactive process involving the resident, DSO/HR/GME and the program. 

Essential functions ensure the safe and smooth delivery of education and patient care and are identified in alignment with program aims to facilitate trainee readiness for independent practice across an appropriate range of clinical settings for that specialty. Transparent documentation of a program’s essential functions is also an important resource for applicants evaluating the training program during recruitment. 

Essential Program Administrative Functions 

Onboarding  

The Resident must: 

• comply with all program and institutional tasks required for credentialing and onboarding by the requested deadlines 
• Other functions/details specific to the program: 
  • The resident must set up imprivata (with support from the program) and maintain it.
  • The resident must ensure ongoing access to EMR at all sites (UW/HMC, VA, SCH)
  • The resident must complete all learning gateway trainings and other trainings required by UW Medicine on time

Program Tasks and Documentation 

The Resident must: 

• participate in all requests for schedule preferences, requests for absence or schedule changes of requests for clinical coverage on the requested timelines or deadlines. 
• Must comply with leave requests within PM&R Residency program’s required timeline (refer to program leave policy)
• complete in a timely manner all evaluations requested for medical students, peer residents, faculty or other members of the team 
• complete MedHub clinical and educational hour logs 
• complete case or procedure logs 
• complete the annual  ACGME Resident Survey 
• complete the program’s annual confidential internal survey 
• complete required examination preparation and/or testing requirements, to include USMLE or COMLEX Step 3, in-training examinations and program-specific guidelines for national board certification 
• Complete USMLE Step 3 before onset of R2 year
• be in attendance at all required program meetings, including semiannual meetings, mentorship meetings, program retreats, etc. 
• Complete other functions/details specific to the program, including specifics on timeliness: 
  • Be on time and prepared for all clinic responsibilities, including morning and afternoon clinics
  • Be on site for all inpatient rotations 7:30am-5pm at a minimum
  • Be on site at the VA for all VA rotations 8am-noon and 1-5pm at a minimum

Essential Program Core Educational Functions 

Didactics 

The Resident must: 

• Comply with all standards for attendance at didactics or other core educational activities 
• Adhere to the preferred mode of attendance (in-person, virtual, hybrid) 
• Attend all didactics on time unless there is an excused absence or excused late arrival

Scholarship 

The Resident must: 

• Comply with all program or specialty requirements for research or scholarship, quality improvement, national or regional conference presentation, publication or scholarly writing or teaching and presentations internal to the program (e.g. journal club, didactics, case conference, M&M, etc.) 
• Other functions/details specific to the program: 
  • Complete one of the four options for scholarly activity requirement specific to our program (refer to scholarly activity requirement page) 

Essential Patient Care Functions 

Presence and preparedness 

The Resident must: 

• present to work as physically, mentally and emotionally fit for duty 
• arrive at the patient care setting on schedule 
• arrive at work in attire appropriate for the professional and safe delivery of patient care 
• meet expectations for chart review or pre-rounding 
• satisfy expectations that precede sign-out and/or departure from the clinical setting, including an appropriate handoff and follow up on all patient assessments/data/studies that will alter care in the near term. 
• Other functions/details specific to the program: 
• Inpatient rotation requirements:
  • Complete daily progress notes before leaving for the day
  • Complete H&P for any new admits before leaving for the day
  • Complete discharge summaries before discharge to SNF or acute care with sufficient time for other team members to complete their tasks (e.g. SW, discharge coordinator). The expectation for discharge summaries for home discharges is to be completed same day and the requirement is for them to be completed within 24 hours of discharge.
  • Chart review each inpatient daily: labs, vital signs, overnight events, bowel/bladder output, prn medication use, and any medically urgent issues
  • Respond to and take care of any messages from staff regarding patient care needs and documentation (e.g. orders, documenting missed minutes, documenting appropriate diagnoses and codes)
  • The expectation is that the resident takes care of any daily medical management and documentation for every patient on their clinical service. Per ACGME requirements, this is a daily minimum of at least 6 patients and a maximum of 14 patients (except during call coverage, weekends, and holiday coverage).
• Outpatient rotation requirements:
  • Chart review patients before clinic
  • Document clinic notes as per attending preference. The expectation is that clinic notes are done by the end of that clinic day and the requirement is that they are done within 24 hours of the encounter.
  • Discuss with attending expectations for: ordering medications, referrals, and billing. This may vary based on site and rotation.
  • In general, we expect that R2 residents will see at least 50% of the clinic patients, R3 residents will see at least 75% of the clinic patients, and R4 residents will see nearly 100% of the clinic patients and complete appropriate documentation.
• EMG rotation requirements:
  • Chart review patients before clinic
  • Discuss with attending any preferences for template for EMG report
  • The expectation is that EMG reports are done by the end of that clinic day and the requirement is that they are done within 24 hours of the encounter.
  • In general, we expect that R3 and R4 residents will see nearly 100% of the EMG patients with varied levels of support from attendings depending on level of training in EMGs and complete appropriate documentation.

Administrative 

The Resident must: 

• complete patient health record documentation on the schedule prescribed by the program or medical center. (Examples include but are not limited to progress notes/visit summaries, discharge summaries, operative or procedure notes, perioperative records)  
• comply with expectations for EHR inbox management, including timely responses to messages from patients, medical staff and tracking and patient follow up of expected results 
• Other functions/details specific to the program, including specifics on timeliness: 
• Within two weeks of receiving, complete work hour documentation, rotation evaluations, didactic evaluations, and faculty evaluations.
• Review goals and objectives of each rotation
• If inpatient: do the hands-on activities in the goals and objectives
• Ask attending for feedback at midpoint
• Complete the didactics, faculty, and rotation evaluations
• Complete didactics requirements (e.g. exam, presentation)
• Ensure you maintain access to SCH and VA by logging in every 30-60 days.
• Log ALL procedures performed or observed. Do not stop logging procedures if you reach your minimums. Do not delay entry of procedures.
• Complete self-assessments and learning plans (and submit)
• Performance evaluation completed with your faculty advisor in fall/winter
• Performance evaluation completed with Program Director or Associate Program Director in spring

By the end of residency

• Complete a scholarly activity and upload it to your assigned onedrive folder.
• Participate in at least one ACGME required activity (community service, professional organization, or institutional committee activities) and complete the self assessment and upload it on your assigned onedrive folder.
• Participate in a performance improvement project or quality improvement project and complete the Resident QI Submission Form and upload it on your assigned onedrive folder.
• Information regarding QI can be found on the RQUIC page.

 

Patient Care Communication 

The Resident must: 

• respond in a timely manner to pages, phone calls and Epic Secure Chat 
• remain within the program-prescribed geographic range while on call or eligible for coverage 
• Other functions/details specific to the program, including specifics on timeliness: 
• Must be within 30 minutes of the hospital while on call
• Must have functioning pager and phone
• Must complete appropriate site-specific EMR sign in/out processes to ensure the primary resident or resident on call is listed at all times
• Must complete site-specific sign-out documentation and communication daily (e.g. Epic handoff, etc.)
• Must evaluate patients in person and communicate with the attending as needed as per on call policy: https://sites.uw.edu/pmrresidency/call-and-transitions-of-care-how-to/

Patient Care Volumes 

The Resident must: 

• work toward (with supervision) or meet benchmarks for patient care volumes in all clinical settings 
• appropriately request and utilize supervision 
• work toward or ultimately meet procedure certification standards 
• Other functions/details specific to the program: 
• For Inpatient Rehab settings meet average census per resident requirements 6-14 census/patient encounters per resident per day (with exception allowances during call coverage, weekends, and holidays).
• Complete 12 months of Inpatient and 12 months of Outpatient experience throughout PM&R residency.
• R2s required to have at least 1 OP month. 
• R4s required to have at least 2 IP month
• Outpatient experience must include:
• Longitudinal care of patients with chronic pain or disability (e.g., continuity care clinic or specialty-specific care clinic)
• Acute and chronic musculoskeletal care
• Limb loss care, prosthetics, and orthotics
• Required Procedure Experience as per ACGME Program Requirements for GME in PM&R effective 7/1/2026 on pg 32/55): https://www.acgme.org/specialties/physical-medicine-and-rehabilitation/program-requirements-and-faqs-and-applications/

Consultation 

The Resident must: 

• appropriately respond to, triage, and staff consultations in a timely manner 
• document findings and recommendations in a timely manner 
• communicate with the requesting service directly (e.g. in-person, phone) in advance of and following the assessment 
• ensure that consultations are staffed and finalized with a faculty member in a timely manner 
• Other functions/details specific to the program, including specifics on timeliness: 
  • Consult rotation requirements:
    • Chart review patients before completing consult
    • Document notes as per attending preference. The expectation is that consult notes are done by the end of that day.
    • Discuss with attending expectations for: communicating with other medical teams, admissions coordinator, patients/families, and how to track and update the patient list. This may vary based on site and rotation.
    • In general, we expect that residents will see 100% of the consult patients, with varied levels of support by attendings depending on level of training and/or clinical workload, and complete appropriate documentation. R4 residents are expected to nearly independently manage consult list and incoming consults/communications

Essential Shift and Schedule Functions 

Settings 

• complete assigned shifts in settings deemed essential by the program, such as inpatient units, NICU, PICU, emergency department, and outpatient specialty and primary care clinics 
• complete assigned away rotations deemed essential by the program 
• Other functions/details specific to the program:
  • Maintain access to EMR for all sites at all times including VA and SCH

Shift length and timing 

The Resident must: 

• complete shifts of all lengths deemed essential by the program, which may include daytime, swing,  
• nights, weekends, and holidays  
• Shifts must not exceed ACGME limits of up to 28 hours per shift, and up to 80 hours per week averaged over a 4 week period 
• where appropriate, comply with designated break lengths (to meet personal needs and not impact patient care) 
• Other functions/details specific to the program (for example: assigned to approximately two 24-hour shifts per month during PGY1): 
  • Must be on site from 730am-5pm at a minimum for inpatient rotations and stay on site to manage sick patients, complete transfers that were initiated during the regular work day, follow up on urgent imaging or lab results.

Call Responsibilities 

The Resident must: 

• complete assigned shifts of overnight call, as deemed essential by the program  
• complete assigned shifts of home call, as deemed essential by the program 
• remain within the prescribed geographic range while on call or eligible for coverage 
• Other functions/details specific to the program (for example: assigned to approximately 4 weeks of overnight call during PGY2): 
  • PM&R residents are expected to take home call on a rotating bases approximately every 4-8 weeks in 3 or 4 day blocks.  This  may include sites that are not their primary clinical stie at the time of call. All residents must complete any required hospital specific training and onboarding before taking call.
  • All home call and weekend rounding responsibilities will meet the ACGME duty hour requirements. The program director is notified of all possible duty hour violations to ensure the program's ongoing compliance with duty hours.
    • Home Call and Duty Hours: Hours where residents are required to go into a clinical site to provide patient care while on home call or rounding do count toward the ACGME requirement 80 hours maximum per week.  Only tasks directly related to patient care duties performed at home count toward the 80 hours total maximum per week. Such tasks may include: completion of medical records; submitting orders, reviewing lab tests, reviewing imaging, consulting with other care providers. These hours should be logged in MedHub if it is required that one completes patient care duties while at home on call.

Essential Cognitive Functions

All Resident Physicians must have the ability to analyze, synthesize, and apply knowledge from clinical experience, readings, and didactic learning to support clinical decision-making, including the abilities to:

• Develop and demonstrate sound clinical judgment in diagnosis, treatment, and prevention of illness.
• Identify, prioritize, and manage patient care and professional responsibilities to support safe, timely, and effective outcomes.
• Apply clinical reasoning effectively in situations involving uncertainty and changing conditions.
• Seek guidance and incorporate input from others as appropriate to support patient care and professional development.
• Reflect on performance and integrate feedback to support continuous improvement.
• Adapt to evolving clinical environments and changing patient care needs.
• Demonstrate reliability through consistent participation in responsibilities and timely completion of assigned tasks.
• Operate effectively in dynamic clinical environments with frequent interruptions and competing priorities.
• Provide guidance, support, and teaching to junior learners, including medical students.

Functions/details specific to the program: 

With or without adaptive or augmentative devices/adaptations/accommodations UW PM&R residents must be able to focus, process and integrate complex information, apply knowledge, and direct goal-oriented thinking to make safe and effective clinical decisions.

• Attention (Focused and Sustained)
  • Ability to maintain focus on relevant clinical information while filtering distractions
  • Capacity to sustain attention over prolonged periods in complex environments
• Working Memory
  • Ability to hold and manipulate multiple pieces of information simultaneously
  • Capacity to track evolving clinical data and manage multiple active problems
• Long-Term Memory (Knowledge Retrieval)
  • Ability to store and recall medical knowledge, clinical patterns, and prior experiences
  • Capacity to apply learned information to new clinical situations
• Information Processing Speed
  • Ability to rapidly process and respond to clinical information
  • Capacity to function efficiently in time-sensitive and high-demand settings
• Executive Function
  • Ability to plan, organize, and structure clinical tasks and decision-making
  • Capacity to prioritize competing demands and manage complex workflows
  • Ability to exercise judgment, including inhibition of irrelevant or incorrect responses
• Clinical Reasoning
  • Ability to analyze, synthesize, and integrate information from multiple sources
  • Capacity to generate differential diagnoses and identify patterns of disease
• Cognitive Flexibility
  • Ability to adapt thinking in response to new or changing information
  • Capacity to shift between different tasks, perspectives, or levels of analysis
• Problem-Solving and Decision-Making
  • Ability to evaluate options, weigh risks and benefits, and select appropriate actions
  • Capacity to make decisions in situations of uncertainty or incomplete information
• Information Integration
  • Ability to combine data from clinical, functional, and psychosocial domains into a unified understanding
  • Capacity for “big picture” thinking across complex systems
• Judgment and Insight
  • Ability to recognize limitations, assess situations accurately, and make sound clinical decisions
  • Capacity for self-monitoring and awareness of evolving clinical scenarios

Essential Communication Functions  (including verbal and written) 

All Resident Physicians must have the ability to communicate effectively in all of their clinical and didactic setting, including the abilities to:

• Gather, interpret, and exchange information effectively with patients, families, and members of the healthcare team.
• Communicate clinical information clearly and in a patient-centered manner to support understanding and shared decision-making.
• Facilitate safe and effective transitions of care, including handoffs, discharges, and referrals.
• Communicate care plans and updates to appropriate members of the healthcare team to ensure continuity and quality of care.
• Recognize and respond appropriately to the perspectives, needs, and emotions of others.
• Collaborate effectively with members of the healthcare team across roles and settings to support coordinated, high-quality care.
• Engage respectfully with individuals from diverse social, cultural, and lived experiences.

Functions/details specific to the program: 

UW PM&R Residents must be able to perform the following communication functions with or without adaptive or augmentative devices, accommodations, or supports:

• Clear and Effective Information Exchange
  • Ability to communicate accurately, concisely, and in a timely manner
  • Ability to convey both routine and complex clinical information
• Tailored Communication
  • Ability to modify communication for individuals with:
    • Cognitive impairments
    • Language barriers
    • Cultural differences
  • Ability to use interpreters, assistive technologies, or alternative communication strategies as needed
• Documentation and Written Communication
  • Ability to produce clear, organized, and clinically accurate written documentation
  • Capacity to convey reasoning, plans, and outcomes in the medical record
• Responsiveness and Communication Flow
  • Ability to respond appropriately and in a timely manner across communication platforms
  • Capacity to manage multiple communication streams simultaneously
• Interdisciplinary Communication
  • Ability to communicate effectively within a multidisciplinary team (PT, OT, SLP, nursing, psychology, social work)
  • Capacity to coordinate, clarify, and prioritize team recommendations
• Consultative Communication
  • Ability to function as a consultant by:
    • Translating rehabilitation principles for other specialties
    • Communicating functional goals, prognosis, and care plans clearly to referring providers
• Synthesis and Recommendation
  • Ability to synthesize complex, multi-source clinical information into clear recommendations
  • Capacity to provide actionable guidance to patients, families, and healthcare teams
  • UW PM&R Residents must be able to communicate complex medical and functional information clearly, accurately, and adaptively across multiple modalities to patients, families, and interdisciplinary teams. Residents must demonstrate effective communication across multiple platforms with or without adaptive or augmentative devices, accommodations, or supports, including: 
• Electronic communication
  • Email
  • Electronic health record messaging (e.g., Epic chat)
• Telephone communication
  • Real-time verbal exchanges with patients, families, and care teams
• In-person communication
  • Face-to-face interactions in clinical, inpatient, outpatient, and team settings

Essential physical functions  (including senses, stances and mobility, manipulation and technical skills) 

All Resident Physicians must have the ability to perform clinical procedures and technical aspects of patient care competently to support safe and effective diagnosis and treatment, including the abilities to:

• Conduct patient assessments to gather and interpret clinical information, supporting comprehensive medical and psychosocial evaluation.
• Sustain performance of clinical responsibilities over scheduled shifts to ensure continuity and quality of patient care.

Functions/details specific to the program: 

 UW PM&R Residents must be able to safely observe, move, examine patients, and perform technical procedures using coordinated sensory, motor, and physical abilities across diverse clinical environments.

Residents must be able to perform the following physical functions with or without adaptive or augmentative devices, accommodations, or supports.

Sensory Functions

• Visual ability
  • Ability to observe patient movement, physical findings, imaging, and monitor screens
  • Ability to interpret visual cues during procedures (e.g., ultrasound guidance)
• Auditory ability
  • Ability to hear and understand patients, families, and team members in various clinical settings
  • Ability to perceive auditory cues (e.g., alarms, patient responses)
• Tactile ability
  • Ability to perform palpation and detect physical findings (e.g., tone, swelling, tenderness)
  • Ability to use tactile feedback during procedures

Stance, Mobility, and Physical Endurance

• Mobility
  • Ability to move independently between clinical sites, inpatient units, outpatient clinics, and educational settings
  • Ability to mobilize in a timely manner for patient care and clinical responsibilities
• Posture and physical positioning
  • Ability to maintain standing, sitting, and transitional postures for clinical care, procedures, and documentation
  • Ability to position self appropriately at bedside, exam tables, and procedural settings
• Endurance
  • Ability to sustain physical activity throughout clinical duties, including prolonged periods of walking, standing, or sitting

Manipulation and Technical Skills

• Physical examination skills
  • Ability to perform comprehensive physical and neurologic examinations
  • Ability to assess strength, sensation, reflexes, coordination, and functional mobility
• Fine motor skills
  • Ability to use hands for precise movements required for examination and procedures
  • Ability to manipulate medical equipment and devices
• Procedural skills
  • Ability to perform or assist with procedures relevant to PM&R, including:
    • Ultrasound-guided procedures (U/S)
    • Electrodiagnostic testing (EMG/NCS)
• Equipment operation
  • Ability to safely and effectively use clinical and procedural equipment
  • Ability to coordinate hand-eye movements during image-guided or technical procedures

Statement Of Nondiscrimination 

The University of Washington prohibits discrimination, harassment and sexual misconduct in any education program or activity that it operates. Individuals may report concerns, make complaints, or direct inquiries to the Civil Rights Compliance Office. View the Statement of Nondiscrimination. 

Key Principles for ADA-Compliant Language: 

• Focus on results, not methods 
• Essential function is a completed task, not how that task is completed 

More Inclusive Term	Example of Physical Demand
Move/traverse	Walk, run
Ascend/descend	Climb
Transport	Carry
Relocate	Lift
Stationary position	Sit, stand
Position, detect, operate	Feel, handle
Maneuver	Pull, push
Attain	Reach
Retrieve from ground level	Squat
Repetitive movement	Performing a task repeatedly
Communicate	Speak, talk, hear
Communicate in written language	Write
Input data	Use keyboard
Position self (to move)	Crouching, stooping, crawling
Work atop	Balance
Determine, identify, assess, recognize	See
Assess	Hear
Review	Read
Adhere	Remember
Apply	Think

 

This reflects requirements, established practices, policies, procedures, and resources as of the date of publication; however, parts of this policy may be updated from time to time in accordance with changes in the law and applicable requirements, established practices, policies, procedures, and resources. Continued participation by a resident in the program will demonstrate agreement by the resident to adhere to the updates.