Skip to main content
Log in

Beyond night float?

The impact of call structure on internal medicine residents

  • Brief Reports
  • Published:
Journal of General Internal Medicine Aims and scope Submit manuscript

Abstract

Limitation of resident working hours has been a critical issue for training programs in recent years. At Providence Medical Center, residents and faculty collaborated in developing goals, implementation strategies, and an evaluation process for a new ward float system. The goals of the float system were to reduce fatigue, facilitate education, maintain continuity of care, and minimize the negative impact of training on residents’ personal lives. Evaluation revealed: 1) 74% of the residents preferred Providence Medical Center float system (PMCF) to either night float (NF) (13%) or standard everyfourth-night call (EFNC) (13%); and 2) PMCF was perceived to ensure quality patient care to a greater degree than was NF, to better facilitate resident education than was NF, and to have a less negative impact on personal lives than was EFNC.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

References

  1. McCall TB. The impact of long working hours on resident physicians. N Engl J Med. 1988;318:775–8.

    Article  PubMed  CAS  Google Scholar 

  2. Colford JM, McPhee SJ. The ravelled sleeve of care—managing the stresses of residency training. JAMA. 1989;261:889–93.

    Article  PubMed  Google Scholar 

  3. Petersdorf RG, Bentley J, Residents’ hours and supervision. Acad Med. 1989;64:175–81.

    Article  PubMed  CAS  Google Scholar 

  4. Asch DA, Parker RM. The Libby Zion case: one step forward or two steps backward? N Engl J Med. 1988;318:771–5.

    Article  PubMed  CAS  Google Scholar 

  5. Reiner SC. The impact of the new code regulations on postgraduate medical education in New York State. NY State J Med. 1989;89:457–61.

    CAS  Google Scholar 

  6. American College of Physicians. Working conditions and supervision for residents in internal medicine programs: recommendations. Ann Intern Med. 1989;110:657–63.

    Google Scholar 

  7. Trontell MC, Carson JL, Taragin MI, Duff A. The impact of the night float system on internal medicine programs. J Gen Intern Med. 1991;6:445–9

    Article  PubMed  CAS  Google Scholar 

  8. Yedidia MJ, Lipkin M Jr. Schwartz MD, Hirschkorn C. Doctors as workers: work-hour regulations and interns’ perceptions of responsibility, quality of care and training. J Gen Intern Med. 1993;8:429–35.

    Article  PubMed  CAS  Google Scholar 

  9. Conigliaro, J, Frishman WH, Lazar EJ, Croen L. Internal medicine housestaff and attending physician perceptions of the impact of the New York State section 405 regulations on working conditions and supervision of residents in two training programs. J Gen Med. 1993;8:502–7.

    Article  CAS  Google Scholar 

  10. Gottlieb DJ, Parenti CM, Peterson CA, Lofgren RP. Effect of a change in house staff work schedule on resource utilization and patient care. Arch Intern Med. 1991;151:2065–70.

    Article  PubMed  CAS  Google Scholar 

  11. Laine C, Goldman L, Soukup JR, Hayes JG. The impact of a regulation restricting medical house staff working hours on the quality of patient care. JAMA. 1993;269:374–8.

    Article  PubMed  CAS  Google Scholar 

  12. Hart RP, Buchsbaum DG, Wade JB, Hamer RM, Kwentus JA. Effect of sleep deprivation of first-year residents’ response times. memory, and mood. J Med Educ. 1987;62:940–2.

    PubMed  CAS  Google Scholar 

  13. Bartle EJ, Sun JH, Thompson L, Light AI, McColl C, Heaton S. The effects of sleep deprivation during residency training. Surgery. 1988;104:311–6.

    PubMed  CAS  Google Scholar 

  14. Ford CV, Wentz DK. The internship year: a study of sleep, mood states, and psychophysiologic parameters. South Med J. 1984;77:1435–42.

    Article  PubMed  CAS  Google Scholar 

  15. Reznick RK, Folse JR. Effect of sleep deprivation on the performance of surgical residents. Am J Surg. 1987;154:520–5.

    Article  PubMed  CAS  Google Scholar 

  16. Deaconson TF. O’Hair DP, Levy MF, Lee MV, Schueneman AL, Condon RE. Sleep deprivation and resident performance. JAMA. 1988;260:1721–7.

    Article  PubMed  CAS  Google Scholar 

  17. Gottleb DJ, Peterson CA, Parenti CM. Lofgren RP. Effects of a night float system on house staff neuropsychologic function. J Gen Intern Med. 1993;8:146–8.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Rosenberg, M., McNulty, D. Beyond night float?. J Gen Intern Med 10, 95–98 (1995). https://doi.org/10.1007/BF02600236

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02600236

Key Words

Navigation