Who should pay for resident education?

Area of Science:

• Medical Education
• Surgical Residency Programs
• Healthcare Economics

Background:

• Hospital budgets often categorize residency program costs under "education."
• This classification is increasingly scrutinized by administrators and payors questioning patient responsibility for medical education costs.
• A need exists to quantify the direct patient care contributions of residents.

Purpose of the Study:

• To assess the workload and patient care hours contributed by surgical residents.
• To provide data supporting the inclusion of residency program costs within hospital operational budgets.

Main Methods:

• A time-motion study was conducted on a pediatric surgical service.
• Workload was quantified by tracking direct patient care hours for general surgical residents.
• Excluded "lag" time and "on call" duties not directly involving patient care.

Main Results:

• General surgical residents dedicate an average of 56.3 hours per week to direct patient care.
• This patient care represents work that would otherwise require physicians, technicians, or nurse practitioners.
• Residents' time commitment is substantial and directly impacts patient management.

Conclusions:

• Residents provide a significant volume of patient care, essential to service operations.
• The costs associated with house staff stipends and residency programs are justified by their direct patient care contributions.
• Including residency costs in hospital budgets is appropriate given the value of resident work.