M.D. in IM here. For the sake of making a point, nothing. Procedures are learnt with deliberate practice over time in residency. For IM, you will either not expected to do anything too technically challenging and can sign off cases you assisted (unless you’re actually doing PCCM or Cards where you should really know these things). Alternatively, you will be expected to do A LOT them and will learn through trial and error. Do your best to do so in a safe way.
Central lines can be challenging but ultimately it’s cannulating a 2-3 cm diameter and advancing a guide wire perpendicularly followed by a line. A LOT can go wrong but jockeying to doing a few as a student doesn’t put you ahead of the pack as a resident. It’s basically like the guy who reads for a month before M1 only to have all the stuff he read get covered in the first hour of lecture.
YMMV with other fields. I’d imagine if you were a surgeon this answer may be different.
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