Abstract
Completing a residency program is a requirement for medical students before they can practice medicine independently. Residency programs in internal medicine must undergo a series of supervised rotations in elective, inpatient, and ambulatory units. Typically, a team of chief residents is charged to develop a yearly rotational schedule. This process is complex, as it needs to consider academic, managerial, regulatory, and legal restrictions while also facilitating the provision of patient care, ensuring a diverse educational experience, balancing the workload, and improving resident satisfaction. This study proposes (1) a multi-stage multi-objective optimization approach for generating yearlong weekly resident rotation schedules and (2) the use of Analytical Hierarchy Process (AHP) to compare schedules across multiple criteria to select those that are more equitable and hence to facilitate their adoption and implementation. Furthermore, the proposed approach allows the scheduling of periodic clinic rotation schemes that are commonly used to facilitate continuity of care, such as “4+1” or the “8+2” policies. In the “4+1” policy residents rotate for four consecutive weeks in different units prior to return for a week to a predetermined clinical post. Similarly, in the “8+2” policy, residents rotate eight weeks across multiple units before doing a two week rotation at a predetermined clinic.
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Acknowledgements
We thank Rochester General Hospital for supporting this study through its Kidd Grant program and for giving us the opportunity to work in this project. In particular, we express our appreciation to Dr. Richard Sterns and his team of chief residents at the Internal Medicine Residency Rotation Program at RGHS for providing us valuable data and for their feedback throughout this work. We also thank Matthew Myers for collecting on-site information that facilitated our understanding of the residency scheduling problem.
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Proano, R.A., Agarwal, A. Scheduling internal medicine resident rotations to ensure fairness and facilitate continuity of care. Health Care Manag Sci 21, 461–474 (2018). https://doi.org/10.1007/s10729-017-9403-9
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DOI: https://doi.org/10.1007/s10729-017-9403-9