Redesigning residency: New models for internal medicine programs

Educators experiment with ways to improve physician training and patient care.

By Myrle Croasdale, AMNews staff. Oct. 23/30, 2006.

With residents' training compressed into 80 hours a week, it's becoming increasing clear there are flaws in the system. There has to be a way, educators say, to improve both physician training and patient care. And, there should be a way to allow programs to draw on their own strengths and use different methods to achieve those goals.

To encourage this structural overhaul, the Accreditation Council for Graduate Medical Education established the Educational Innovations Project.

In March, 17 internal medicine programs were selected to prepare new models, that, if successful, could be replicated by other institutions.

Here are three examples:

Private physicians with patients at Beth Israel Deaconess Medical Center, one of Harvard Medical School's teaching affiliates, may get a pleasant surprise when they do rounds. If a doctor's patient is being treated by the general medicine department, the admitting intern or resident is likely to be right there to answer questions.

That's the direct benefit of a new system the hospital implemented July 1. Unlike in most big teaching hospitals, internal medicine residents here are assigned to a specific floor, with all their patients in the same unit. Residents get new patients only when a bed on their floor opens up.