A Day in the Life of an Internal Medicine Resident – A Time Study: What Is Changed from First to Third Year?

Figures & data

Table 1 PGY1 vs PGY3 Work Day Time Allocation

Activity	Interns		Senior Residents		P-value*
	Hours (mean)	%	Hours (mean)	%
Average Work Day Length	12.5 ± 0.8		11.0 ± 0.8		<0.001
Direct Patient Care	2.2 ± 0.5	18.0 ± 4.3	1.8 ± 0.5	16.1 ± 4.4	0.045
Indirect Patient Care	2.5 ± 0.7	19.7 ± 4.9	2.9 ± 0.4	26.0 ± 4.5	0.221
Patient care discussions	1.3 ± 0.5	10.4 ± 4.0	1.9 ± 0.3	17.0 ± 3.3	0.011
Patient presentations during rounds	0.2 ± 0.1	1.5 ± 0.9	0.1 ± 0.1	0.7 ± 0.8	0.023
Sign in/out with other residents	0.3 ± 0.1	2.7 ± 0.9	0.2 ± 0.1	1.7 ± 1.0	0.011
Phone calls	0.7 ± 0.4	5.1 ± 2.6	0.7 ± 0.2	6.6 ± 1.8	0.634
Computer Work	5.1 ± 0.8	40.1 ± 4.5	3.6 ± 1.0	32.0 ± 7.3	0.001
Computer login/logout	0.1 ± 0.1	0.8 ± 0.4	0.1 ± 0.0	0.6 ± 0.3	0.060
Clerical work	0.2 ± 0.1	1.4 ± 0.8	0.2 ± 0.1	1.5 ± 1.5	0.777
Computer Retrieval of Information	1.6 ± 0.4	12.8 ± 3.3	1.6 ± 0.4	14.2 ± 3.4	0.763
Review patient chart	1.1 ± 0.4	8.9 ± 2.7	0.9 ± 0.2	8.0 ± 1.9	0.103
Review patient labs/diagnostic exams	0.5 ± 0.2	3.9 ± 1.2	0.7 ± 0.3	6.2 ± 2.4	0.073
Computer Entry	3.2 ± 0.8	25.1 ± 5.1	1.8 ± 0.9	15.7 ± 7.7	0.002
Writing notes	1.1 ± 0.5	9.1 ± 4.3	0.4 ± 0.5	3.5 ± 4.4	0.005
Writing orders	0.4 ± 0.2	3.5 ± 1.7	0.5 ± 0.1	4.3 ± 1.3	0.771
Patient admission notes, orders	0.6 ± 0.6	4.9 ± 4.5	0.4 ± 0.4	3.8 ± 3.8	0.402
Patient discharge notes, orders	1.0 ± 0.6	7.6 ± 4.5	0.5 ± 0.5	4.1 ± 4.3	0.051
Education	0.4 ± 0.4	3.0 ± 3.8	0.8 ± 0.5	7.3 ± 4.4	0.046
Formal conferences	0.2 ± 0.4	1.7 ± 3.6	0.5 ± 0.4	4.7 ± 4.1	0.117
Reading additional information	0.1 ± 0.1	0.9 ± 0.6	0.2 ± 0.1	1.4 ± 1.1	0.406
Teaching other residents, students	0.1 ± 0.1	0.4 ± 0.7	0.1 ± 0.1	1.2 ± 1.3	0.141
Allied Health Professionals	0.3 ± 0.1	2.5 ± 1.1	0.4 ± 0.2	3.5 ± 1.7	0.392
Direct interaction with nurses, social workers	0.1 ± 0.1	1.1 ± 0.6	0.2 ± 0.2	1.8 ± 1.8	0.451
Care coordination rounds	0.2 ± 0.1	1.4 ± 0.7	0.2 ± 0.1	1.7 ± 0.6	0.740
Travel/Walking	0.9 ± 0.1	7.1 ± 1.1	0.7 ± 0.2	6.8 ± 1.9	0.053
Social/Other	1.2 ± 0.6	9.7 ± 5.0	0.9 ± 0.5	8.4 ± 4.6	0.238

Note: *Two-sample t-test comparing mean hours between groups.

Abbreviation: PGY1, post-graduate year 1; PGY3, post-graduate year 3.

Table 2 Resident Tasks: Perceived Time vs Actual Time (minutes)

Variable	Perceived (N=20)	Actual (N=20)	Difference	P-value*
	Mean ± SD	Mean ± SD
Direct care	129.4 ± 56.1	120.3 ± 32.7	9.1 ± 65.6	0.54
Indirect care	166.8 ± 53.6	169.5 ± 36.5	−2.7 ± 58.6	0.84
Computer retrieval	98.2 ± 63.0	110.8 ± 23.1	−12.7 ± 63.2	0.38
Computer entry	145.1 ± 86.8	136.3 ± 58.1	8.8 ± 61.5	0.53
Nurse contact	40.6 ± 25.5	20.9 ± 9.2	19.7 ± 26.1	<0.01
Education	47.5 ± 36.9	35.3 ± 30.1	12.2 ± 31.9	0.10
Travel	32.8 ± 22.2	49.1 ± 10.6	−16.3 ± 23.0	<0.01
Personal time	45.3 ± 39.1	63.1 ± 33.0	−17.8 ± 34.7	0.03

Note: *Paired t-test comparing the mean difference in perceived-actual minutes.

Table 3 Resident Activities During off-Duty Hours

Variable	Interns (N=10)		Residents (N=10)
	Hours (mean)	Percentage	Hours (mean)	Percentage
Sleep	6.6	55.5	6.55	51.5
Unaccounted	2.35	20	2.5	20
Meals	0.65	5	0.65	5
Other	0.45	4	0.85	6.5
Commute	0.6	5	0.55	4
TV	0.5	4	0.5	4
Social networking	0.3	2.5	0.4	3
Educational reading	0.25	2	0.45	3.5
Recreational reading	0.1	1	0.2	1.5
Athletic activity	0.1	1	0.1	1