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A Day in the Life of an Internal Medicine Resident – A Time Study: What Is Changed from First to Third Year?
BACKGROUND: In the past decade, internal medicine residencies have undergone major changes in competency-based assessments, work-hour restrictions and the implementation of the electronic medical record. The aim of this study is to compare a typical day of a first year post-graduate (PGY1) to that o...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Dove
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7125302/ https://www.ncbi.nlm.nih.gov/pubmed/32280293 http://dx.doi.org/10.2147/AMEP.S247974 |
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author | Wieler, Jane Lehman, Erik Khalid, Muhammad Hennrikus, Eileen |
author_facet | Wieler, Jane Lehman, Erik Khalid, Muhammad Hennrikus, Eileen |
author_sort | Wieler, Jane |
collection | PubMed |
description | BACKGROUND: In the past decade, internal medicine residencies have undergone major changes in competency-based assessments, work-hour restrictions and the implementation of the electronic medical record. The aim of this study is to compare a typical day of a first year post-graduate (PGY1) to that of a third year post-graduate (PGY3) internal medicine resident and examine if the differences in their days demonstrate the American Board of Internal Medicine’s (ABIM) desired progression towards competency-based milestones and unsupervised practice. METHODS: We conducted an observational time study documenting 14,103 minutes, 9 major categories, and 17 subcategories while shadowing 10 internal medicine PGY1s and 10 PGY3s during inpatient, non-call days. The following day, house staff completed surveys of their perceived time allocation of the previous 24 hours. RESULTS: PGY1s spent an average of 12.5 hours managing an average of 6 patients. Thirty-eight percent of their time was spent on the computer, 21% discussing patients and 18% directly with patients. PGY3s, overseeing an average of 12 patients, worked 1.5 hours less per day (p<0.001), had 1.5 hours less computer time (p=0.001), 24 minutes less direct patient contact (p=0.045), and 36 minutes more patient care discussions (p=0.011). CONCLUSION: The difference between PGY1s’ and PGY3s’ daily time allocations is minimal. Whereas a PGY3 spends 1.5 hours less than a PGY1 on writing computer notes and discharges, they also work 1.5 hours less per day. The additional 36 minutes of patient care discussions was the only significant time quantity difference that would be considered a higher level of practice for the PGY3 compared to the PGY1. With residents now caring for fewer patients, there has been a marked increase in computer time per patient for both PGY1s and PGY3s. |
format | Online Article Text |
id | pubmed-7125302 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Dove |
record_format | MEDLINE/PubMed |
spelling | pubmed-71253022020-04-10 A Day in the Life of an Internal Medicine Resident – A Time Study: What Is Changed from First to Third Year? Wieler, Jane Lehman, Erik Khalid, Muhammad Hennrikus, Eileen Adv Med Educ Pract Original Research BACKGROUND: In the past decade, internal medicine residencies have undergone major changes in competency-based assessments, work-hour restrictions and the implementation of the electronic medical record. The aim of this study is to compare a typical day of a first year post-graduate (PGY1) to that of a third year post-graduate (PGY3) internal medicine resident and examine if the differences in their days demonstrate the American Board of Internal Medicine’s (ABIM) desired progression towards competency-based milestones and unsupervised practice. METHODS: We conducted an observational time study documenting 14,103 minutes, 9 major categories, and 17 subcategories while shadowing 10 internal medicine PGY1s and 10 PGY3s during inpatient, non-call days. The following day, house staff completed surveys of their perceived time allocation of the previous 24 hours. RESULTS: PGY1s spent an average of 12.5 hours managing an average of 6 patients. Thirty-eight percent of their time was spent on the computer, 21% discussing patients and 18% directly with patients. PGY3s, overseeing an average of 12 patients, worked 1.5 hours less per day (p<0.001), had 1.5 hours less computer time (p=0.001), 24 minutes less direct patient contact (p=0.045), and 36 minutes more patient care discussions (p=0.011). CONCLUSION: The difference between PGY1s’ and PGY3s’ daily time allocations is minimal. Whereas a PGY3 spends 1.5 hours less than a PGY1 on writing computer notes and discharges, they also work 1.5 hours less per day. The additional 36 minutes of patient care discussions was the only significant time quantity difference that would be considered a higher level of practice for the PGY3 compared to the PGY1. With residents now caring for fewer patients, there has been a marked increase in computer time per patient for both PGY1s and PGY3s. Dove 2020-03-30 /pmc/articles/PMC7125302/ /pubmed/32280293 http://dx.doi.org/10.2147/AMEP.S247974 Text en © 2020 Wieler et al. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). |
spellingShingle | Original Research Wieler, Jane Lehman, Erik Khalid, Muhammad Hennrikus, Eileen A Day in the Life of an Internal Medicine Resident – A Time Study: What Is Changed from First to Third Year? |
title | A Day in the Life of an Internal Medicine Resident – A Time Study: What Is Changed from First to Third Year? |
title_full | A Day in the Life of an Internal Medicine Resident – A Time Study: What Is Changed from First to Third Year? |
title_fullStr | A Day in the Life of an Internal Medicine Resident – A Time Study: What Is Changed from First to Third Year? |
title_full_unstemmed | A Day in the Life of an Internal Medicine Resident – A Time Study: What Is Changed from First to Third Year? |
title_short | A Day in the Life of an Internal Medicine Resident – A Time Study: What Is Changed from First to Third Year? |
title_sort | day in the life of an internal medicine resident – a time study: what is changed from first to third year? |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7125302/ https://www.ncbi.nlm.nih.gov/pubmed/32280293 http://dx.doi.org/10.2147/AMEP.S247974 |
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