I agree with those who say that residency is much more grueling than it needs to be. If the goal were simply to train competent physicians, I think it could be done with each of us putting in much fewer hours, doing much less work, in the same number of years. However, that would require tremendous efficiency in the system, and great motivation amongst attendings to teach at every available opportunity. Neither of those is possible. While there are hospitals along the entire spectrum of efficiency, most of them are nowhere close to the top. There is an almost unthinkable amount of waste in most systems, both in terms of resources and time. They could hire more workers to reduce the amount of scut residents have to do. But, why do that when you've got residents who don't have much of a choice but to submit to whatever schedule there is? As for attendings, once again, there are great ones and there are horrible ones. But even the best of them don't teach at every available opportunity. That means that we don't learn from every patient, which is just as well. I can't speak for anyone else, but there is only so much learning I want to do on any given day. Not every patient has something to teach; sometimes, we just want to get our work done and be gone.
I believe that if we went to, say, a sixty-hour week in a system with more efficiency, where highly-trained physicians aren't doing things a high-school graduate could do just as well, we could turn out physicians who are just as competent and probably less jaded. But there is no incentive for anyone to do that; except, of course, the residents. But, the residents don't have much of a choice in the matter. And, once we graduate from training, most of us will go on leaving the next generation of residents to fend for themselves.
An average resident makes roughly $10-12/hr working 80hrs/week. Some fast-food restaurants pay their cashiers that much. If hospitals had to pay us according to our skill level by the hour, I guarantee that there would be a lot more help on the floors. Anyone disagree?