Hospitalist involvement in internal medicine residencies.

CONTEXT: The ways hospitalists interact with and contribute to internal medicine residencies in the United States have been described locally, but have not been documented on a national level.

OBJECTIVES: To describe the penetration of hospitalists into medicine residency faculty nationally, and document their contributions to teaching activities.

DESIGN, SETTING, AND PARTICIPANTS: Survey of all 386 internal medicine residency directors in the United States in 2005 (272 respondents) and 2007 (236 respondents).

MEASUREMENTS: Number of teaching hospitals utilizing hospitalists, number of programs utilizing hospitalists to teach, hospitalist teaching duties, and number with hospitalist tracks.

RESULTS: In 2005, program directors recalled 54% of teaching hospitals employed hospitalists before and 73% after implementation of work-hour limitations. Of those employing hospitalists, 92% of programs in the Northeast and West used them to teach. Two years later, the Midwest (78%) and South (76%) continued to lag behind in the proportion of teaching hospitalists. Specific teaching activities of hospitalists included: attending on teaching service (92%), conducting rounds (81%), observation of clinical skills (67%), lectures (68%), and morning report (52%). Seven percent of program directors reported other duties of hospitalists, including: supervising procedures, reviewing night float patients, serving as associate program directors, and writing curricula. Eleven percent of training programs had hospitalist tracks.

CONCLUSIONS: As hospitalists have become prevalent and have become efficient clinicians in community and university hospitals, the majority of internal medicine residencies have enlisted them to provide rounds, lectures, and bedside teaching. A small number of residencies are beginning to develop tracks to facilitate this new career option for graduates.