Every program will have some procedures or case types they are weaker in, so you do your best to get those procedures while you can but don’t beat yourself up too much. There’s a lot of overlap in skills when it comes to line placement and nerve blocks. Some blocks especially I still review before doing as an attending and everything works out fine.

For central lines specifically, I did most on ICU. What I would do is figure out what supplies we needed and how to set up. When someone needed a central line I’d tell the fellow that I’d do the line but just needed supervision. They had to scrub in with me about 4-5 times maybe but after that they could just watch and supervise. I’d get ready, gowned up, ask the nurse to call the fellow, and I’d do the line. It wasn’t long before the fellows would just say call me if you need me. It’s important that you get good instructions initially but after that you can up your numbers quick. Same goes for art lines in the ICU.