Journal of General Internal Medicine

, Volume 21, Issue 9, pp 961–965

Internal medicine residents’ clinical and didactic experiences after work hour regulation

A survey of chief residents
  • Leora I. Horwitz
  • Harlan M. Krumholz
  • Stephen J. Huot
  • Michael L. Green
Original Articles

DOI: 10.1007/BF02743145

Cite this article as:
Horwitz, L.I., Krumholz, H.M., Huot, S.J. et al. J GEN INTERN MED (2006) 21: 961. doi:10.1007/BF02743145

Abstract

BACKGROUND: Work hour regulations for house staff were intended in part to improve resident clinical and educational performance.

OBJECTIVE: To characterize the effect of work hour regulation on internal medicine resident inpatient clinical experience and didactic education.

DESIGN: Cross-sectional mail survey.

PARTICIPANTS: Chief residents at all accredited U.S. internal medicine residency programs outside New York.

MEASUREMENTS AND MAIN RESULTS: The response rate was 62% (202/324). Most programs (72%) reported no change in average patient load per intern after work hour regulation. Many programs (48%) redistributed house staff admissions through the call cycle. The number of admissions per intern on long call (the day interns have the most admitting responsibility) decreased in 31% of programs, and the number of admissions on other days increased in 21% of programs. Residents on outpatient rotations were given new ward responsibilities in 36% of programs. Third-year resident ward and float time increased in 34% of programs, while third-year elective time decreased in 22% of programs. The mean weekly hours allotted to educational activities did not change significantly (12.7 vs 12.4,P=.12), but 56% of programs reported a decrease in intern attendance at educational activities.

CONCLUSIONS: In response to work hour regulation, many internal medicine programs redistributed rather than reduced residents’ inpatient clinical experience. Hours allotted to educational activities did not change: however, most programs saw a decrease in intern attendance at conferences, and many reduced third-year elective time.

Key Words

internship and residencyworkloadeducationpersonnel staffingscheduling

Copyright information

© Society of General Internal Medicine 2006

Authors and Affiliations

  • Leora I. Horwitz
    • 1
    • 2
    • 3
  • Harlan M. Krumholz
    • 2
    • 3
  • Stephen J. Huot
    • 3
  • Michael L. Green
    • 3
  1. 1.VA Connecticut Healthcare SystemWest HavenUSA
  2. 2.Robert Wood Johnson Clinical ScholarYale University School of Medicine, IE-61 SHMNew Haven
  3. 3.Department of Internal MedicineYale University School of MedicineNew HavenUSA