Possible responses by the privileging body:
(1) approval without reservation
(2) approval with stipulation or limitation, usually review of performance by the chief of service or department
(3) deferral pending completion of documentation, training course or monitoring of performance (inadequate CME, performance concerns, etc.)
(4) denial of privileges, due to insufficient training
Evaluation Data
Completion of an approved residency and/or fellowship program in a relevant area:
(1) eligibility to take the Board examination
(2) passage of the Board examination
Adequate training in the procedure, with documentation of number and type of procedures performed:
(1) as part of residency or fellowship program
(2) completion of a formal training program in the procedure, with additional experience as needed with a trained physician
(3) for some low risk procedures, medical practice using the procedure safely for several years may be considered sufficient ("grandfathering")
Confirmation of proficiency:
(1) for recent trainees, proctoring by a physician experienced in the procedure
(2) for current practitioners, ongoing review of procedures for success, failure and complication rates
Maintenance of competence:
(1) continuing education
(2) performance of sufficient numbers of the procedure to maintain skills
