The impact of resident duty hours reform on the internal medicine core clerkship: Results from the clerkship directors in internal medicine survey

PURPOSE: In July 2003, resident duty hours regulations were implemented. The impact of these regulations on medical student education has received minimal attention. The objective of this study was to evaluate the perceptions of internal medicine clerkship directors about the impact of resident physician duty hours reform on medical student teaching, assessment, and clerkship structure. METHOD: A survey was sent to 114 institutional members of Clerkship Directors in Internal Medicine in May 2004. The survey included 17 attitude items rated on a 5-point Likert scale, five items related to clerkship structure, and four open-ended questions. Descriptive statistics were performed on the responses. RESULTS: Ninety-six surveys were returned (84%). The majority of respondents did not believe duty hours reform had a positive impact on clerkship students' educational experiences, whereas 48.3% agreed or strongly agreed that residents had more difficulty evaluating students' clinical skills. There was not a significant change in inpatient clerkship structure after duty hours implementation. Time for teaching students, concerns about a shift-work mentality, and student continuity with their teams were major challenges. Impact on ambulatory internal medicine rotations was minimal. CONCLUSIONS: Internal medicine clerkship directors are concerned about the impact of resident duty hours reform on student education. Additional studies of this educational impact are needed.