Residency programs should consider rotating more outpatient blocks

More outpatient scheduling blocks may reduce resident burnout without reducing medical knowledge, according to an article published in JAMA Network Open. A team led by Daniel Heppe, MD, from the University of Colorado School of Medicine and VA Eastern Colorado Health Care System in Aurora, found that residents reported improved overall health and well-being, as well as reported improved ability to attend educational sessions without skimping out on clinical reasoning or skills. "Burnout is a work-related syndrome of depersonalization, emotional exhaustion, and low personal achievement that is prevalent among internal medicine resident trainees," Heppe and colleagues wrote, noting that "training schedules that create protected time for residents to engage in activities such as scholarship and quality improvement are needed." The Heppe team has been evaluating the format and content of residency programs for several years now. This time, it evaluated the association of a 4 + 4 block schedule (rotating four inpatient weeks with four outpatient weeks) compared to a 4 + 1 block schedule (rotating four inpatient weeks with one outpatient week) to measure schedule-associated burnout, wellness, and self-reported professional engagement, and clinical preparedness. Beginning with the academic year 2019-2020, the internal medicine residency program (IMRP) at a university, a U.S. Veterans Administration hospital, and a local hospital, all located in Colorado, implemented a new 4 + 4 ...
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