Roles and Responsibilities of Medicine Subinternship Directors

BSTRACT Background The internal medicine (IM) subinternship (also referred to as acting internship) plays a crucial part in preparing medical students for residency. The roles, responsibilities, and support provided to subinternship directors have not been described. Objective We sought to describe the current role of IM subinternship directors with respect to their responsibilities, salary support, and reporting structure. Design Nationally representative, annually recurring thematic survey of IM core clerkship directors with membership in an academic professional association as of September 2017. Participants A total of 129 core clinical medicine clerkship directors at Liaison Committee on Medical Education fully accredited U.S./U.S.-territory-based medical schools. Main Measures Responsibilities, salary support, and reporting structure of subinternship directors. Key Results The survey response rate was 83.0% (107/129 medical schools). Fifty-one percent (54/107) of respondents reported overseeing both core clerkship inpatient experiences and/or one or more subinternships. For oversight, 49.1% (28/53) of subinternship directors also reported that they were the clerkship director, 26.4% (14/53) that another faculty member directed all medicine subinternships, and 18.9% (10/53) that each subinternship had its own director. The most frequently reported responsibilities for the subinternship directors were administration, including scheduling, and logistics of student schedules (83.0%, 44/53), course evaluation (81.1%, 43/53), and setting grades 79.2% (42/53). The modal response for estimated FTE per course was 10–20% FTE, with 33.3% (16/48) reporting this level of support and 29.2% (14/54) reporting no FTE support. Conclusions The role of the IM subinternship director has become increasingly complex. Since the IM subinternship is critical to preparing students for residency, IM subinternship directors require standard expectations and adequate support. Future studies are needed to determine the appropriate level of support for subinternship directors and to define essential roles and responsibilities.