Duty‐hour limitations led to many changes in the residency experience at academic medical centers. Studies have suggested the quality of life of residents has improved but have questioned the impact on resident education and patient care. Specifically, residents have been noted to miss more educational experiences like conferences with a concomitant decline in attending‐led education.


In 2004, 2 hospitalist—physician assistant (H‐PA) teams were formed to supplement the existing 6 resident ward teams. These H‐PA teams admitted 8‐12 new patients every weekday between 8 am and 3 pm. It was during these times that most educational activities for house staff were scheduled — including morning report (7:30 am ‐8:30 am), attending teaching rounds (9:00 am‐11:00 am), and the noon conference (noon‐1:00 pm). The patients admitted by the H‐PA teams were covered by a nighttime hospitalist during evening hours.


  • 1.

    The 3‐ year ABIM rolling pass rates for residents increased from 85% in 2003 to 93% in 2005.The average scores for PGY3 residents on the in‐service training exam increased from 63 (32nd percentile nationally) in 2003 to 68 (50th percentile nationally) in 2005.

  • 2.

    Resident attendance at educational conferences increased from 51% (2003‐2004) to 73% ( 2005‐2006).

  • 3.

    The average length of stay for patients on the general internal medicine teams decreased from 5.21 days in 2003 to 4.38 days in 2005.

  • 4.

    The mortality rate for patients on the general internal medicine teams decreased from 2.45% in 2003 to 1.56% in 2005.

  • 5.

    A subsidy was necessary to staff the nighttime coverage for the patients admitted by the H‐PA teams.


A unique staffing method was employed, with hospitalist—PA teams admitting patients during times of peak resident education. This intervention has been associated with improvements in resident education and patient care outcomes.

Author Disclosure:

S. Singh, None; J. H. Petkova, None; A. Gill, None; T. Mohyuddin, None; A. Goyal, None; S. Denson, None; P. Loftis, None; J. Verburg, None; M. O. Frank, None; L. A. Biblo, None.