Unfortunately, most hospitalists don’t recognize the enormous challenge one faces in filling the schedule until they are given the task.
Unless you were a chief medical resident, you probably didn’t learn or practice scheduling in the course of your medical training. Inevitably, everyone wants and expects to get their choice of days off. Of course, that is rarely possible.
How do you make everyone happy? It is important to recognize that making everyone happy every time is not possible. But it is possible and important to be fair to everyone all the time. There are some steps you can take to ensure the scheduling process is fair.
The first step is to set appropriate expectations. It is critical for the group leader and the staff member making the schedule to help each group member understand the enormous challenges that come with scheduling.
Providers who understand the difficulties of scheduling will be more understanding and accommodating in their requests.
The second step is to establish and clearly state the rules of engagement. For example, be explicit in explaining the rules for submitting requests and the deadline for requests. Avoid misconceptions by stating when the final schedule will be revealed.
The last step is to clearly state how to handle requests for schedule changes. Many hospitalist groups keep track of who works which holidays so the distribution of work on holidays is fair from year to year.
I have one last suggestion. Consider rotating the job of scheduling so everyone understands firsthand the challenges of the job. To entice people to assume this responsibility, the job should come with remuneration—either salary support and/or preference in choosing their own holiday schedule.
Of course, recognize that not everyone will want the job or be good at it. An effective group leader helps individuals identify opportunities and helps them succeed.
Foreign Medical Grads
Question: What’s your opinion on the effect of foreign medical graduates in the U.S.?
IMG in Cincinnati
Dr. Hospitalist responds: The U.S. healthcare system would be quite different without foreign (aka international) medical graduates (IMGs), who play important clinical, educational, administrative, and research roles.
Some physicians and patients believe medical education outside this country is inferior. In some cases, they are correct—in others, they could not be more wrong. Medical education outside this country varies in standards and curricula.
Many people are not aware that IMGs who wish to enter an Accreditation Council for Graduate Medical Education residency of fellowship program in the United States must have Educational Commission for Foreign Medical Graduates (ECFMG) certification. ECFMG certification requires the applicant to pass a series of examinations, including United States Medical Licensing Examination (USMLE) Steps 1 and 2.
ECFMG certification is also required before an applicant can take Step 3 of the USMLE and is required before a physician can obtain an unrestricted license to practice medicine in the United States.
I suspect some IMGs face discrimination in this country because some may speak with an accent. But truth be told, the United States healthcare system could not exist without the contributions made by IMGs. TH