Medical school can be brutal, and it’s making many of us suicidal

Re:Medical school can be brutal, and it’s making many of us ... by stephencanon on Tuesday October 11, 2016 @01:05AM (#12681993)

There's no other path to becoming a doctor in the US. You can choose to go into a specialty with more relaxed hours, but you need to go through residency no matter what. If you want to be a doctor, you put up with it, like the generations before you. A sufficient number of residents organizing could do something about it, but (a) no one has time to organize when they're working 90 hour weeks and (b) there's a significant Stockholm syndrome effect in play.

It's worth noting that there have been several studies over the years investigating whether reduced hours produce better outcomes; they don't seem to. Shorter hours means more shift changes and patient handoffs, which is the source of more errors than tired residents. Also, keep in made that getting the same experience in a specialized field like neurosurgery with fewer hours per week would require extending the training program even further. It's already seven years beyond medical school, often with a one year fellowship after residency. Extending it another few years isn't really a viable option unless we significantly increase the autonomy and salary that residents receive.

[ Parent | on HN ]

Re:Medical school can be brutal, and it’s making many of us ... by mixmastamyk on Tuesday October 11, 2016 @02:29AM (#12682225)

You can only learn so much per day. It sounds like you are making excuses to ignore basic human rights (recognized post-industrial revolution) such as ~40 hour weeks in favor of indentured servitude. Appeals to "outcomes" do not supersede workers rights.

Sorry, I don't buy it.

[ Parent | on HN ]

Re:Medical school can be brutal, and it’s making many of us ... by kahrkunne on Tuesday October 11, 2016 @03:34AM (#12682421)

Human lives supersede workers rights. If you don't like it don't go to medical school.

[ Parent | on HN ]

Re:Medical school can be brutal, and it’s making many of us ... by dagw on Tuesday October 11, 2016 @05:31AM (#12682768)

That's a bullshit argument. If hospitals really cared about human lives, they would keep a staff level that ensured that patients would be seen by doctors that where rested and focused. People die because doctors and nurses who've been on their feet for the past 20 hours are unfocused make stupid mistakes and hospitals simply don't care because dealing with the occasional accidental death is cheaper than hiring more doctors, and we as a society let them get away with it.

[ Parent | on HN ]

Re:Medical school can be brutal, and it’s making many of us ... by bryanlarsen on Tuesday October 11, 2016 @06:35AM (#12683025)

As the OP noted, people die at a higher rate when you switch to shorter shifts because information loss during shift change causes more mistakes than tired physicians.

In many hospitals doctors are paid hourly, so shorter shifts wouldn't cost the hospital money.

[ Parent | on HN ]

Re:Medical school can be brutal, and it’s making many of us ... by TheGreatPotatoe on Tuesday October 11, 2016 @08:55AM (#12683895)

The patient hand-off problem is real. I just feel like there is a better solution than having these folks work 80+ hours a week.

[ Parent | on HN ]

Re:Medical school can be brutal, and it’s making many of us ... by stephencanon on Tuesday October 11, 2016 @11:19AM (#12685178)

You can hire twice as many residents and make residency twice as long so they get the same total training at 40 hours a week.

You'll have to significantly increase resident salaries, and allow residents to move between hospitals to deal with life events. This isn't impossible, but it's politically infeasable while everyone is talking about cutting medical costs (total pay to residents would need to go up ~10-fold for this to work out). It's a bad situation today, but there isn't a simple magic wand to fix it with minor changes.

[ Parent | on HN ]

Re:Medical school can be brutal, and it’s making many of us ... by mixmastamyk on Tuesday October 11, 2016 @01:17PM (#12686374)

They won't have to train twice as long, because a great portion of those long days are wasted due to fatigue. All these reasons are excuses for sweatshop conditions that wouldn't be tolerated elsewhere.

[ Parent | on HN ]

Re:Medical school can be brutal, and it’s making many of us ... by stephencanon on Tuesday October 11, 2016 @03:43PM (#12687886)

Have you gone through residency training? While we both consider the conditions inhumane, my wife is absolutely clear on the fact that even at the end of a shift she's still learning a ton. Surgical residents commonly stay beyond their shifts to scrub in and assist or observe especially interesting cases. Based on my conversations with my wife and other residents, you would absolutely need to extend residency to get the same training with fewer hours.

[ Parent | on HN ]