The ED is staffed with 14 young and two to three senior physicians and supported by a range of more experienced physicians and specialists from the other departments of the hospital. In the Danish hospital system, the young physicians are primarily residents and are in charge of triage, admissions and the primary care. After admission, the details of the patient’s condition are communicated by the admitting physician to a more experienced physician, often a specialist and always a doctor with at least one year’s training within the specialty in question. The more experienced physician is obliged to come to the ED and review the patient and to initiate further investigations or treatment if necessary. To evaluate the time physicians spent on different tasks during a dayshift, we chose a work sampling (WS) approach. Three physicians were observed every three minutes and their activity was registered in a predefined classification system (table 1). Classification was tested in a pilot study and followed the categories suggested by Tipping et al with subcategories adjusted to our ED [3]. One exception was that communication with patients and relatives was considered part of direct patient care in this study. The observers generally attempted to minimize interruption of the physicians’ work by not entering the exam room if they were able to hear what task the physician was performing through the door. For this reason, the physicians were asked to leave the door ajar when possible during the course of this study. data collection

Three trained observers (two secretaries and the 1st author) observed nine residents during dayshifts from 20 to 24 February 2012. Dayshifts for admitting doctors were from 8 am to 6 pm, while the physician primarily responsible for minor orthopaedic traumas in the ER worked from 8 am to 4 pm (fast track). The three resi-