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July 1991

On-Call Experience of Medical Interns

Author Affiliations

Stony Brook, NY

Arch Intern Med. 1991;151(7):1463. doi:10.1001/archinte.1991.00400070201040

To the Editor.—  The time study of the on-call experience of medical interns at the Henry Ford Hospital (Detroit, Mich) performed by Nerenz et al1 raises several interesting issues for us as educators in an Internal Medicine Residency Program in New York.Certainly, the authors articulate the end of the "romance era" of the 36-hour on-call experience of medical house staff, and rightfully so. However, at least with our experience since the inception of the New York State health code regulation 405 limiting house staff work hours, we are concerned with the loss of continuity of care of new admissions by our house staff. This is particularly so during the crucial first 36 hours of hospitalization, a period during which most of the important diagnostic and therapeutic decisions take place for many patients. Night float admitting house staff teams, chronic patient flow problems (as experienced by just about any