Residency

Tip of the week: Analyze rotation schedules to balance service and education

Residency Program Insider, April 19, 2013

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A common solution for the service versus education issue is redesigning the training program to provide more protected educational time. To do this, program directors may have to evaluate rotation schedules and which attending physicians receive resident support. Coordinators can pull reports from the ACGME Case Log System, compile information on evaluations, analyze the data, and provide program directors with information they will consider when redesigning the program.

Coordinators should examine the following information when considering how to redesign the program:
• Evaluations: Review the evaluations residents complete for duplicate rotations. Evaluate rotations that expose residents to the same disease processes and determine which one teaches the subject matter most effectively. Consider eliminating the other rotation.
• ACGME Case Log System: Monitor how much time it takes residents to meet patient encounter requirements on a particular rotation. If residents consistently acquire the patient cases required long before the rotation finishes, consider adding more education time to that rotation, or reduce the time residents spend on that rotation and create a new rotation.
• Coordinators should look at reports in the Case Log System to monitor patient contact or case procedure numbers that residents acquire at the facilities they rotate through. Determine whether residents are getting the patients/cases they need. If the amount of patient contacts is decreasing, consider moving the residents to another facility that will increase the resident educational experience.

Surgical programs should also take note of the role faculty members assign residents during procedures. Determine which faculty members allow residents to participate the most in procedures and to learn technical skills.

Once the yearly schedule is complete, develop rotation schedules. Rotation, also referred to as call schedules, indicate which residents are on a rotation and the hours they work. Typically, the task falls to the chief residents, but some programs assign this to the program coordinator or a member of the department administrative staff. However, even in programs where others write the schedule, the program coordinator has a hand in monitoring the schedule to ensure it is in compliance with all ACGME, specialty board, and duty-hour standards.

This tip is from the Residency Coordinator’s Handbook, Second Edition, by Ruth H. Nawotniak, MS, C-TAGME. 
 



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