Table 2:
Definition of a clinical full-time effort
| Specialty | Definition of 1 CFTE |
|---|---|
| Nonshift specialties | |
| Adult medicine and pediatrics | |
| Primary care medicine and pediatrics | 8 clinical sessions/wk |
| Procedural subspecialties (eg, cardiology, gastroenterology, and pulmonology) | 5–8 clinical sessions/wk |
| Nonprocedural subspecialties (eg, endocrinology, genetics, nephrology, infectious diseases) | 5–8 clinical sessions/wk |
| Radiology, surgery, ophthalmology | 4 full clinical d/wk |
| Ambulatory psychiatry | 28–32 h of direct patient contact |
| Shift-based specialties | |
| Hospital medicine | |
| Adult medicine | 180–182 daytime 12-h shifts/y at academic sites (with variability across the 2 affiliates that were interviewed), and 200 daytime shifts/y at community-based sites affiliated with primary AMCs For nocturnists, a CFTE represented 144 nighttime shifts/y; not all affiliate hospitals provided hospitalist services at community sites |
| Pediatrics | |
| Affiliate 1 | 120 weekday shifts (~10–12 h/shift, no set hours) and 12 weekends |
| Affiliate 2 | 126 8-h daytime shifts/y (with additional time spent prerounding and postshift for work completion) and 12 nighttime shifts (15 h/shift) |
| Emergency medicine | |
| Affiliate 1 | Academic physicians: 1200 clinical h/y (8–9 h/shift, yielding a maximum of 150 shifts/y) Nonfaculty (community-based) physicians: 1500–1600 clinical h/y Minimum of 0.4 CFTE required for faculty who were exclusively clinical |
| Affiliate 2 | “Academic-heavy” track: 20 h/wk of clinical work (8–9 h/shift, or 6–10 h of urgent care shifts) “Academic-light” track: 20–32 h/wk “Community” track (physicians without academic appointments): 32 h/wk |
AMC, academic medical center; CFTE, clinical full-time effort.