A total of 54 final-year students were asked to keep a diary of their daily activities over a three-week period at the beginning of their internship in Internal Medicine. Students categorized their activities – both medical and non-medical - according to whether they had: (1) only watched, (2) assisted the ward resident, (3) performed the activity themselves under supervision of the ward resident, or (4) performed the activity without supervision. The activities reported on a particular day were matched with a ward specific workload-index derived from the hospital information system, including the number of patients treated on the corresponding ward on that day, a correction factor according to the patient comorbidity complexity level (PCCL), and the number of admissions and discharges. Both students and ward residents were blinded to the study question.

A total of 32 diaries (59 %, 442 recorded working days) were handed back. Overall, the students reported 1.2±1.3 supervised, 1.8 ±1.6 medical and 3.6±1.7 non-medical activities per day. The more supervised activities were reported, the more the number of reported medical activities increased (p<.0001). No relationship between the ward specific workload and number of medical activities could be shown.