Hidaka Brandon, Smith Emily R, Furlano Anthony J, Nordin Terri, Ruppel Lindsey M, Waheed Abdul
Department of Family Medicine, Mayo Clinic Health System, Eau Claire, WI.
Department of Family Medicine, Mayo Clinic Health System, Rice Lake, WI.
Fam Med. 2025 Apr;57(4):276-285. doi: 10.22454/FamMed.2025.822335. Epub 2025 Feb 5.
Physician scheduling affects job satisfaction and retention. This study explores how family medicine residency inpatient staffing relates to core faculty retention and program director (PD) perception of faculty satisfaction with work-life integration.
A total of 280 family medicine residency PDs responded to the 2023 Council of Academic Family Medicine Education Research Alliance survey. We used the ꭓ2 test to explore associations among program demographics, inpatient staffing characteristics, faculty retention, and PD-reported faculty satisfaction with work-life integration. We measured associations among pairs of ordinal variables with Spearman's correlation.
In two-thirds (66%) of programs, faculty cover the inpatient service at least every 8 weeks, with 40% of programs reporting averages of 70 or more hours per inpatient week; nevertheless, most programs' faculty were perceived to be satisfied with less than 10% turnover. The number of hours per week was inversely associated with PD-reported faculty satisfaction (r=-0.21, P=.001). Faculty turnover was directly associated with community size (r=0.17, P=.01). Faculty turnover was more likely to be greater than 10% if the number of hours per inpatient week was more than 89 (odds ratio 12.4, P=.02). Faculty turnover, PD-reported faculty dissatisfaction, and plans to change inpatient staffing were all correlated (r>0.28, P<.0001).
Most family medicine residencies have core faculty cover the inpatient service at least once every 8 weeks, during which they work at least 60 hours per week. Longer hours are associated with lower perceived faculty satisfaction of work-life integration, with a threshold effect on faculty turnover. Family medicine residency programs must carefully balance the needs of residents, the community served, and faculty themselves.
医生排班会影响工作满意度和留任率。本研究探讨家庭医学住院医师培训项目的住院部人员配置与核心教员留任率以及项目主任(PD)对教员工作与生活平衡满意度的看法之间的关系。
共有280名家庭医学住院医师培训项目的PD对2023年学术家庭医学教育研究联盟理事会的调查做出了回应。我们使用卡方检验来探讨项目人口统计学、住院部人员配置特征、教员留任率以及PD报告的教员工作与生活平衡满意度之间的关联。我们用Spearman相关性分析来测量成对有序变量之间的关联。
在三分之二(66%)的项目中,教员至少每8周负责一次住院部服务,40%的项目报告称每位住院医师每周平均工作70小时或更多;然而,大多数项目的教员离职率低于10%时被认为是满意的。每周工作时长与PD报告的教员满意度呈负相关(r = -0.21,P = 0.001)。教员离职率与社区规模呈正相关(r = 0.17,P = 0.01)。如果每位住院医师每周工作时长超过89小时,教员离职率超过10%的可能性更大(优势比12.4,P = 0.02)。教员离职率、PD报告的教员不满以及改变住院部人员配置的计划均具有相关性(r>0.28,P<0.0001)。
大多数家庭医学住院医师培训项目都有核心教员至少每8周负责一次住院部服务,在此期间他们每周至少工作60小时。工作时长越长,教员对工作与生活平衡的满意度越低,且对教员离职率有阈值效应。家庭医学住院医师培训项目必须仔细平衡住院医师、所服务社区以及教员自身的需求。