Medical Student Perceptions of 24-Hour Call

Abstract

Objective: To assess the medical student perception and experience of a 24-hour call requirement, and to learn if improvements can be made to improve the 24-hour call requirement.

Design: Medical students completing their required surgical clerkship over 1 academic year at our institution were surveyed prior to their clerkship and on the last week of clerkship regarding their perceptions and experience with 24-hour call.

Setting: This study was performed at the University of Minnesota, in Minneapolis, Minnesota, a medical school and tertiary medical center.

Participants: Two hundred one medical students were given the option to complete an anonymous survey before and after their required surgical clerkship.

Results: Response rate for the preclerkship survey was 70% (n = 140) and 58% (n = 117) for the postclerkship survey. The mean age of respondents was 26 years, and the majority of students were in their third year of medical school. After completing the clerkship, students interested in surgery more often agreed the 24-hour call requirement should remain (51% versus 31%, p = 0.01). Students rotating at a Level I Trauma Center were also more likely to agree the call requirement should remain (59% versus 33%, p = 0.008). Medical students generally had less concerns (mental health, fatigue, mistakes, and grade performance) related to 24-hour call after completion of the clerkship. Concerns about the effect of 24-hour call on study schedule remained high in both pre and postclerkship groups.

Conclusions: Medical students have concerns about the experience prior to the clerkship that diminished by its completion. To improve medical student perceptions and overall experience of 24-hour call, frequency of shifts could be limited and the 24-hour call requirement sites could be shifted to Level I Trauma Centers.

Keywords: Burnout; General surgery; Interpersonal and Communication Skills; Practice-Based Learning and Improvement; Student clerkship director; Student education; Working hours.