Redesign of an internal medicine ward rotation: operational challenges and outcomes. Academic Article uri icon

start page

  • 97

end page

  • 100


  • Introduction: In anticipation of the 2011 ACGME duty hour requirements, we redesigned our internal medicine resident ward experience. Our previous ward structure included a maximum 30-hour duty period for postgraduate year-1 (PGY-1) residents. In the redesigned ward structure, PGY-1 residents had a maximum 18-hour duty period.Methods We evaluated resident conference attendance and duty hour violations before and after implementation of our new ward redesign.We administered a satisfaction survey to residents and faculty 6 months after implementation of the new ward redesign.Results Before implementation of the ward redesign, 30-hour continuous and 80-h/wk duty violations were each 2/year, and violations of the 10-hour rest between duty periods were 10/year for 74 residents. After implementation of the ward redesign, there were no 30-hour continuous or 80-h/wk duty violations, but violations of the 10-hour rest between duty periods more than doubled (26/year for 75 residents). Duty hours were reported by different mechanisms for the 2 periods.Conference attendance improved. Resident versus faculty satisfaction scores were similar. Both groups judged overall professional satisfaction as slightly worse after implementation. Conclusion Our ward rotation redesign eliminated 30-hour continuous and 80-h/wk duty violations as wellas improved conference attendance. These benefits occurred at the cost of more faculty hires, decreased resident elective time, and slightly worse postimplementation satisfaction scores.

date/time value

  • 2012
  • March 2012

Digital Object Identifier (DOI)

  • 10.4300/JGME-D-11-00092.1

PubMed Identifier

  • 23451316


  • 4


  • 1