Wednesday, December 3, 2008

Medical residents

The Institute of Medicine has issued a report on the training of new doctors: Expert Panel Seeks Changes in Training of Medical Residents (the link is to the NY Times story, the report is at
Resident Duty Hours: Enhancing Sleep, Supervision, and Safety)

The medical residency is the first step on a medical career, and is shaped by competing forces: the desire of the medical profession to limit new entry, the training needs of new docs, and the needs of patients. The latest report focuses on the latter by suggesting that residents should have some scheduled sleep time...

"...the worry is that the huge workload imposed on residents poses a risk to patient safety. The long hours of often unsupervised residents were found to have contributed to the 1984 death of 18-year-old Libby Zion in New York City, a finding that eventually led to a series of changes, including limiting residents to an 80-hour workweek and 30-hour shifts.
But the expert panel said those reforms were not enough. Caps on work hours are often not enforced, and many residents still do not get enough sleep, putting doctors and patients at risk for fatigue-related mistakes. While the new recommendations do not reduce overall working hours for residents, the report says no resident should work longer than a 16-hour shift, which should be followed by a mandatory five-hour nap period.
The committee also called for better supervision of the doctors-in-training; prohibitions against moonlighting, or working extra jobs; mandatory days off each month; and assigning chores like drawing blood to other hospital workers so residents have more time for patient care."

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