Association between time spent on internal medicine attending rounds and in training examination scores among resident physicians in Japan

Attending rounds are central to internal medicine residency, but whether spending more time on rounds improves learning remains unclear. We examined the association between weekly attending round time and in-training examination performance among postgraduate residents in Japan. This nationwide cross-sectional study included postgraduate year 1 and 2 residents who took the 2023 General Medicine In-Training Examination (GM-ITE) and completed a post-examination survey. Weekly internal medicine attending round time was categorized as none, 1–2, 3–5, 6–10, or ≥ 11 h, with 1–2 h as the reference. Mixed-effects linear regression models estimated adjusted mean differences in internal medicine domain and total GM-ITE scores. Among 6,347 residents, 44.1% reported 1–2 h of weekly attending rounds. Compared with 1–2 h, 6–10 h (adjusted mean difference, − 0.47; 95% CI − 0.77 to − 0.17) and ≥ 11 h (− 0.70; 95% CI − 1.22 to − 0.19) were associated with lower internal medicine scores. Longer bedside attending round time during general internal medicine rotations was also associated with lower scores. Longer attending round duration was not associated with better examination performance, suggesting that the educational value of rounds may not be captured by duration alone.