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Re:Sleep is more important than food by pyre on Wednesday March 09, 2011 @12:17PM (#2305539)
To some extent the sleep deprivation is a weeding process/learning experience in and of itself. Being able to perform under stress/lack of sleep is a good quality in a doctor.
Re:Sleep is more important than food by mv on Wednesday March 09, 2011 @02:20PM (#2305991)
I am a 3rd year in medical school, and firmly believe that sleep deprivation is a terrible weeding process. If a doctor is sleep deprived I do not want them touching me with a ten foot pole. They make enough mistakes as it is! Sure you argue that they limit work hours, but I can tell you first hand that these limits are only paid lip service to, and I routinely see residents work 80+ (sometimes 90+) hours a week. Oh and the max shift is 16 hours now so calculate out how you get to 80+ hours. You can't report your program because they will lose accreditation and you'd have to go somewhere else to get this scam of being 'board certified', and you can't really threaten because your program can find a reason to dispose of you. real big catch-22.

(just for kicks, if you worked 10hour days for 7 days a week that is only 70 hour work week... doctors work at least 12 hour days, and usually 16 hour days to get to the full 80 hours!)

Oh and as far as weeding out?

Most 'weeding' out happens first and second year of medical school. In my class alone about 10% of the class failed first year exams, and they were forced to repeat or retake the whole year. (which SUCKS when you just paid $37,000 for a year of school that meant nothing). Then Second year weeding happens again with STEP1 licensing exam:

"Overall pass rates for first time USMLE Step 1 test takers are: 92% for U.S. M.D. medical school graduates, 81% for U.S. D.O. osteopathic medical school graduates, and 73% for international medical school graduates" http://en.wikipedia.org/wiki/United_States_Medical_Licensing...

Fail a year or a board exams? You pretty much can only be a psychiatrist or family doctor with little or no hope of every specializing.

Re:Sleep is more important than food by RK on Wednesday March 09, 2011 @03:45PM (#2306316)
I agree with this (expect that USMLE is not a board exam).

My SO is a medical resident. They really are placed in unstable situations (to use a math/physics term). They are required to work 80 hr/week. If they report working more than 80 hr/week they get into trouble for a duty hours violation and yelled at for being "inefficient". If they report less than 80 hr/week they get in trouble for being slackers (a.k.a. "unprofessional", actually that's a catch-all phrase for anything the speaker doesn't like). No serious thought seems to be given to increasing staff levels.

Re:Sleep is more important than food by joe_the_user on Wednesday March 09, 2011 @03:12PM (#2306189)
You pretty much can only be a psychiatrist or family doctor with little or no hope of every specializing.

And that's the problem (not your problem but the profession's problem) - the hope is to specialize whereas being a family doctor is the booby prize.

Re:Sleep is more important than food by yblokhin on Wednesday March 09, 2011 @03:23PM (#2306227)
Can you please explain more why psychiatrists get it easier?
Re:Sleep is more important than food by mv on Wednesday March 09, 2011 @04:01PM (#2306382)
you must 'match' into a specialty. If you do not have a good rank or board scores you can only match into the 'lower' residencies like family or psych
Re:Sleep is more important than food by joe_the_user on Thursday March 10, 2011 @01:01AM (#2308256)
Uh, yes but why are thse 'lower'?

Well I know abut family but why psych?

Re:Sleep is more important than food by eru on Wednesday March 09, 2011 @03:50PM (#2306334)
I guess people don't want therapy at night?
Re:Sleep is more important than food by philwelch on Wednesday March 09, 2011 @12:42PM (#2305630)
How many doctors are actually weeded out after they get to their residency, though? First year of med school, absolutely. Residency is a bit late.
Re:Sleep is more important than food by RK on Thursday March 10, 2011 @01:45AM (#2308359)
By the time you hit residency, you are so far into debt that not having a job that pays $100k+ (eventually) is suicidal. That being said, some people do drop out.

I know one person who dropped out, but was at married to another resident, so has a safety net. Another resident dropped out due to a medical condition that prevented him from standing for hours a day and landed a job at McKinsey. Another friend dropped out and became a receptionist! Eventually she went into a residency for a lower stress specialty (surgery -> psychiatry).

Re:Sleep is more important than food by esoteriq on Wednesday March 09, 2011 @01:55PM (#2305913)
Does it have to be? There are only 133 Medical Schools in the U.S. and there is a marked shortage of doctors in some areas, most notably general family doctors.

The only area that learning how to deal with sleep deprivation would be a benefit is surgery and critical care areas (ICUs). But then again, if you could schedule things better and get more doctors in, maybe these doctors don't have to learn how to function on 5 hours of sleep.

I think you're right to the extent that the current medical service system requires doctors to learn to sleep less and less while functioning on an acceptable level (note that I didn't say satisfactory or even exceptional). But I think that's begging the question. Shouldn't we be able to change the current system and allow doctors to focus on building skills/knowledge, not the ability to function without sleep.

tl;dr: sleep deprivation is not a necessary part of being a doctor if we change the system, so saying that doctors must learn how to deal with sleep deprivation is a circular argument.

Re:Sleep is more important than food by gaius on Wednesday March 09, 2011 @02:40PM (#2306066)
The shortage is purely artificial; the AMA keeps a cap on numbers to make sure pay stays high.
Re:Sleep is more important than food by wtn on Wednesday March 09, 2011 @03:40PM (#2306297)
The Maine Experiment suggests that when an area has more doctors, they administer more procedures, many of them unnecessary. This counters your simple supply-demand argument--doctors actually manipulate demand.

http://www.npr.org/templates/story/story.php?storyId=1135711...

Re:Sleep is more important than food by esoteriq on Wednesday March 09, 2011 @04:41PM (#2306570)
Yes, but that doesn't refute my point. My point was sleep deprivation doesn't make better doctors or even encourage better doctors to stay.

Frankly, I'm surprised that as many doctors make it through - the working conditions are pretty terrible. Maybe the pay makes up for it, but you only get paid well once you get out of your residency or fellowship.

Better conditions will probably produce better doctors, not subpar doctors.

Re:Sleep is more important than food by joe_the_user on Wednesday March 09, 2011 @03:09PM (#2306172)
Yes it is. Of course hazing/weeding processes are the means used to achieve this.
Re:Sleep is more important than food by Symmetry on Wednesday March 09, 2011 @02:11PM (#2305959)
Thats a big problem though. We really shouldn't be asking practicing doctors to perform under a lack of sleep like we currently do. The problem is that we have too few doctors (in the US) and part of that problem is the fact that we weed out potential doctors who can't function well without sleep or who don't want a job where they are run ragged.

EDIT: Applied s/two/too