Background Internal medicine residents often express general dissatisfaction with their clinic experience. This may influence their future career choice, as well as the career choices of medical students who rotate through clinic. Few studies have been done that identify modifiable factors that may improve resident satisfaction with clinic.
Methods On-line, anonymous survey administered to medicine house staff at two Mid-South university-affiliated continuity clinics, one based in a privately owned, for-profit hospital and the other in a public safety-net hospital. The survey addresses clinic environment, organization, workload and teaching. Open-ended questions were qualitatively analyzed to isolate themes and concerns not already identified by questions using a 5-point Likert scale for rating levels of satisfaction. Factors for which at least 25% of residents had answered that they were “unsatisfied” or “very unsatisfied” were identified and interventions will be implemented to address those concerns. Follow-up surveys are planned for one year later, to evaluate the impact of interventions on ongoing resident satisfaction levels and future career choices.
Results Pilot study results suggest that the most important factors contributing to resident dissatisfaction are the availability and organization of the paper chart, the amount of time available to spend with patients, the process used to inform patients regarding urgent and emergent laboratory results, the pace of clinic activities, and the amount of “scut work” involved in locating needed data. House staff rate teaching and the diversity of disease processes they see very highly. Full house staff survey data will be analyzed and compared to the preliminary results for validation purposes, and to determine what, if any, specific differences exist between resident perceptions of each of the two Continuity Clinics.
Conclusion House staff perceive clinic to be a stressful environment over which they have little control. We identify specific areas that can be addressed to ensure that residents have a more satisfying primary care experience.