Medical Interns Still Overworked

[Celebration]

http://www.webmd.com/content/article/127/116571.htm

Sept. 5, 2006 -- New doctors still often work long hours, despite rules to the contrary, and may be more accident-prone when exhausted.

Those findings are reported in JAMA, The Journal of the American Medical Association.

Doctors' training, or residency, traditionally includes working long hours. Some shifts may last more than 24 hours, although not all are that long.

In 2003, new rules went into effect for all doctors-in-training (residents) in the U.S. Those rules, issued by the Accreditation Council for Graduate Medical Education (ACGME), include:

Residents may work up to 30 hours in a row.
Residents may work up to 80 hours a week, averaged over four weeks.
Residents must have 1 work-free day every 7 days.
But during the first year those rules were in effect, more than eight in 10 first-year residents, called interns, reported working more than the rules permitted, according to Christopher Landrigan, MD, MPH, of Harvard Medical School, and colleagues.

[BlueJazz]

1. Yes-Sir-eee ..That's what I want. If I ever get hurt at night and go...

...to the Hospital, I hope I get some poor Bastard that hasn't slept in 2 days
and feels like he's in the Twilight Zone for lack of rest.

[papau]

2. So paying residents $10/hr for their 80 hr week is not an incentive

to become a M.D.?

$10/hr is above the minimum wage, and those $200,000 school loans can be deferred for a few years for hardship - gee- sounds like we are giving the good life to our finest and brightest.

[SheilaT]

3. What I find scary is

how many current MDs continue to justify this kind of work load.

For enlightenment, read the book Intern by Dr. X. It came out around 40 years ago, and was pretty much the very first tell-all of its type. Now these kinds of memoirs are routine, but that one shocked a lot of people that an intern would have the audacity to keep a journal and publish it.

What's instructive is how much medicine has changed, how little of the technology we take for granted was around then. And how much sleep he actually got during his overnight shifts.

And I, for one, would not want to be treated by a sleep-deprived caretaker.

The justification that is generally given is continuity of care, ignoring the fact that eventually the resident gets off duty and hands the patients off to the next resident. Why having well-rested residents is a bad idea escapes me.

Oh. And sleep research shows that sleep-deprived people do not learn well and do not make good decisions.

[Sgent]

4. FYI

a medical intern is a specific term for someone who has completed their medical degree, and is in their first year of post graduate study. Generally, they have not yet taken the final portion of their licensure exams, and do not have a license to practice medicine outside an academic setting.

A medical resident is someone who has completed thier intern year, passed their licensure exams, and in most states (California requires 2 years post-grad training) holds an unrestricted medical license. They are completing their specialty training.

The distinction is blurred in many instances since most physicians no longer complete a separate internship -- but rather the first year of their specialty training includes the internship requirements.

[Trillo]

5. The new rules seem to be a form of hazing.

New rules similar to old rules(?).

Those rules, issued by the Accreditation Council for Graduate Medical Education (ACGME)

It seems as if this resident stage of learning is designed to teach by immersion without any time to reflect or think. Just do, do fast, do tortuously long hours, and whatever you do, do not think deeply (for that takes time and a sleep refreshed mind), just believe what you are told.

Perhaps this is one of the techniques by which longer-term institutional changes by the younger generations are prevented and keeps the old cycles continuing. It's always been this way, so it always shall be(?).

Sleep deprivation is reported as one of the torture techniques used in Bush's terrorists' prisons.

[bemildred]

6. Slave owners always think slavery is beneficial. nt