Medical Interns Dissatisfied With Flexible Residency Programs

medical interns at patients bed
medical interns at patients bed
Interns in flexible programs are more likely to be dissatisfied with their educational experience.

HealthDay News — Interns in flexible programs are more likely to be dissatisfied, while program directors are more likely to satisfied, according to a study published online in the New England Journal of Medicine to coincide with the Academic Internal Medicine Week 2018, held from March 18 to 21 in San Antonio.

Sanjay V. Desai, MD, from the Johns Hopkins University School of Medicine in Baltimore, and colleagues randomized 63 US internal medicine residency programs to be governed by standard duty-hour policies of the 2011 Accreditation Council for Graduate Medical Education or by more flexible policies. Observations of the activities of interns, surveys of trainees and faculty, and intern examination scores were assessed.

The researchers found that the mean percentages of time that interns spent in direct patient care and education did not differ between the groups, nor were there differences in trainees’ perceptions of an appropriate balance between clinical demands and education, or in program directors and faculty assessments of whether trainees’ workloads exceeded their capacity. Interns in flexible programs were more likely to report dissatisfaction with multiple aspects of training, including the quality of education and overall well-being (OR, 1.67 and 2.47, respectively). Directors of flexible programs were less likely to report dissatisfaction with multiple educational processes.

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“Interns in flexible programs were less satisfied with their educational experience than were their peers in standard programs, but program directors were more satisfied,” the authors write.


Desai SV, Asch DA, Bellini LM, et al. Education outcomes in a duty-hour flexibility trial in internal medicine [published online March 20, 2018]. N Engl J Med. doi:10.1056/NEJMoa1800965