Reducing ward-clinic conflicts by rotational scheduling of house staff

Many internal medicine residency training programs are being modified to permit each resident to gain more outpatient experience, including providing continuous care to a defined panel of patients for three years. Increasing emphasis on these outpatient responsibilities and education, however, places demands on the resident that conflict with his responsibilities on the inpatient wards. In this paper the authors describe the development and implementation of a rotational scheduling system aimed at substantially alleviating the conflict between inpatient and outpatient responsibilities. During the first year of operation 84 percent of house staff members indicated their preference for continuing the system in future years.