The University of Tennessee Obstetrics & Gynecology resident physician work efficiency

Physicians in training are commonly evaluated on their medical knowledge and clinical skills but rarely in work efficiency. We developed a Resident Efficiency Score (RES) to study the clinical productivity and efficiency of residents.

Physician Post Graduate Year (PGY) 1, 2, 3 and 4 trainees rotating on the gynecologic oncology service recorded their clinical work (using the Relative Value Units (RVU) and Medicare 1997 Evaluation and Management guideline) and their working hours. RES was calculated using total RVU per work hour logged (RES=RVU/hour).

From July 1, 2007 to June 31, 2008, 36 residents rotated thru the gynecologic oncology service and were included in the study The residency included 23 female and 13 male residents, consisting of 23 Caucasians, nine African Americans, two East Indians, one Hispanic and one Iranian. These residents, under the supervision of three gynecologic oncology faculty members, evaluated 1,168 new, 7,011 clinic and 1,568 hospital patients during the study period. Residents' average weekly hours were similar: PGY 1 (55), PGY 2 (53.5), PGY 3 (60.5), PGY 4 (53.4) (p= 0.88). Overall resident work efficiency increased from PGY 1 (RES 4.4) to PGY 2 (RES 5.6) to PGY 3 (RES 6.2), and regressed in PGY 4 (RES 5.2) (p=0.04). Work efficiency was similar among all PGY years in the operating room (p=0.5) and on the weekend (p=0.18).

In this study, resident physicians worked more productively up to the third year and then regressed. RES may be a useful tool in helping resident to evaluate their clinical work efficiency.