Half time = Half trained

The kinder and more gentle days of residency are upon us. Residents are limited to 80 hours a week. This is a big change. The term resident came from the fact that doctors in training resided in the hospital. You litterally ate, breathed and lived medicine. This was the way to cram as much training and experience as possible into the years you spent after medical school. Residencies got longer and longer as there was more to know. In surgery, the saying was that if you were on call every other night, you missed half the cases and had half the experience. This came from the fact that the days were filled with the routine cases but the emergencies that came in while on call prepared you to handle anything. Now we have surgery residents checking out like they work in a factory. "I reached my limit and its time to go!" In many cases the hour limits have decreased the experience by a third to a half.

Here is one of the problems. Is a surgeon who has only 2/3 of the experience handling emergencies as good as one who has done more? Should we increase the length of residencies? Surgery is already 5 to 7 years. Neurosurgery can be 7. This does not count fellowships. All this is after 4 years of college and 4 of medical school.

Was I tired in residency? You bet, I learned to catnap, eat standing and to follow the rules of "The House of God". See a bed, lay in it. See food, eat it. See a chair, sit in it. When I finished residency it was better but I still had the long hours because I was supervising residents.

Here is another thing. Out of residency, you cant have your beeper go off and tell the ER that "no, I cant help with that emergency, I have already worked my hours." "Sorry that the baby has decels and a c-section is needed, Ive reached 80." Residency prepares you for what its like in the real word. There are no work hour restrictions in the real world.

I tried to expain our work ethic to a friend who is an attorney and explained that you go home when the work is done and get called in when there is more work to do. We base things on the job to do. You go home when the patients are stable. He didn't understand, he gets paid by the billable hours, the longer something takes, the more money he makes. It is to his advantage to drag things on as long as possible. He can go home anytime he wants. It not like people are dying!