Over a typical 24-hour shift, first year residents training in internal medicine spend just three hours on direct patient care and only 1.8 hours on education, a U.S. study suggests.


Most of their time - an average of 15.9 hours out of every 24-hour shift - is consumed instead by “indirect patient care,” primarily involving interactions with medical records and documentation, the study found.
“Even when interns were face-to-face with patients, much of it was spent multitasking - interacting with the electronic health record or coordinating care with other health care workers,” said lead study author Dr. Krisda Chaiyachati of the University of Pennsylvania Perelman School of Medicine in Philadelphia.
“Based on evidence and my own personal experiences, multitasking makes it difficult to complete any of these individual tasks well,” Chaiyachati said by email. “When doctors are multitasking, at minimum, we are creating inefficiencies in how we manage sick patients, and, hopefully, we are not creating mistakes that lead to harm.”
The U.S. spends more than $12 billion annually on graduate medical education, researchers note in JAMA Internal Medicine. Despite this considerable investment, research to date hasn’t offered a clear picture of how residents, or doctors-in-training, balance patient care and educational activities.

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