How Many Hours Do Internal Medicine Residents At University Of Toronto Spend Onboarding At Hospitals Each Year? A Cross-sectional Survey Study

BackgroundBurnout among medical residents is common. One source of burnout is the need to complete redundant administrative tasks such as onboarding processes at various hospitals. ObjectivesTo quantify the time residents at the University of Toronto spend onboarding at teaching hospitals, to identify areas of redundancy in onboarding processes, and to identify trainee perceptions of onboarding processes. MethodsWe conducted a quality improvement survey of core internal medicine residents at the University of Toronto where residents rotate through multiple different teaching hospitals. The primary outcome was time spent onboarding. Secondary outcomes included perceptions of the onboarding process, and impact on well-being. Results41% (N=93) of all Internal Medicine residents completed the survey. Most (n=81, 87%) rotated through at least four hospitals and 24 (26%) rotated through more than 5 in the preceding year. The median number of hours spent on the onboarding process was 5 hours per hospital (IQR 1-8) and these tasks were often completed when trainees were post-call (82%, n=76) or outside of work hours (97%, n= 90). The cumulative number of hours spent each year on onboarding tasks by the 93 trainees was 2325 hours (97 days) which extrapolates to 5625 hours (234 days) for all 225 trainees in the core internal medicine program. Most residents reported high levels of redundancy across hospital sites (n=79, 85%) and felt that their well-being was negatively affected (73%, n=68). ConclusionsThe median internal medicine resident at the University of Toronto spent 5 hours onboarding for each hospital. There is considerable redundancy and the process contributes to self-reported burnout.