Evaluating Health Transformation Plan’s Specialist Residency Program in Hospitals of Tehran University of Medical Sciences: A Qualitative Approach

Hospitals are recognized as a 24/7 center in all health systems. Under the health transformation plan, one specific program was envisaged to improve the response to clients during non-business hours and holidays via different specialties being stationed in the hospitals, especially emergency departments, since 2014. It was expected to have a significant impact on emergency performance and patient satisfaction. Therefore, the present study aims to qualitatively evaluate the program of specialists residing in the emergency department, examining its strengths and weaknesses and opportunities for improvement.

In this qualitative study, a semi-structured interview was conducted with 19 specialists, two super-specialists, four general practitioners and two experts, mainly as resident physicians and deputy director of treatment at Tehran University of Medical Sciences. Data analysis was performed using thematic analysis strategy with the help of MAXQDA software.

The strengths included a transparent communication and job descriptions, a reliable access to specialist services at evening and night shifts and speeding up patients’ care and discharge. As such, the lack of monitoring system for physicians’ performance, payment issues and possible damage to student education were the main challenges and weaknesses

The importance of hospitals without the presence of physicians, especially in teaching and public hospitals, will be very small. The instructions of the resident physician’s program were not strictly implemented as opposed to the other programs of the health transformation plan. Numerous causes and factors were identified in this study for this negligence that can to some extent pave the way for health policy makers and managers.