Public Tolerance of Length of Physician Training

[filter07]

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Since medical training is subsidized by the federal government, and especially since there is a severe predicted shortage of physicians in the United States, do you think the public would continue to accept the prolonged length of training for physicians?

For example, to train a general surgeon, it's 5 years. To train a cardiothoracic surgeon, it's 7-8 years. Often research years are added, making the training 9-10 years. These years are subsidized in the form of loan deferments and payments to residency programs. If the public knew it took up to 10 years of government subsidies after graduation from college and medical school (about 18 years of post-high school education) to train one person to be a cardiothoracic surgeon for 20 years, do you think they would still think it's a good investment? Or maybe they would demand a more efficient training paradigm? Finally, is it really appropriate for these highly educated physicians to extend their residency even longer with research or elective time, especially since only a small fraction of these trainees become academic physicians?

If I were just a normal taxpayer, I would demand that my tax dollars be better spent. 18 years of post-high school training for 20 years of medical practice seems highly inefficient and I wouldn't want to pay for that.

 

[UMED122]

I couldn't disagree more. Residents are tremendously productive for the amount they get paid. What other professionals are paid 40 thousand dollars or so to work 80+ hours a week? Maybe it's inefficient from the trainees perspective, but definitely not in terms of taxpayer money going to the resident. Taxpayers are getting their money's worth and then some.

 

[Faebinder]

- All the work done by medical students in hospitals for free. (heck they pay for it even!)

- All the work done by residents in the hospitals that technically requires a midlevel or even an attending to do... for the price of a 40 something thousand a year.

- Board eligable/certified attendings doing the work of subspecialists in fellowships for 50 something thousand a year... Plus production of high level clinical research without paying a researcher for it.

Mmmm.... Sounds like the best gig ever for the public. Slave labor.

 

[dragonfly99]

agree with the above 2 posts.
OP, I think you're thinking about it totally backwards/wrong, from a financial standpoint.

 

[Law2Doc]

Also agree. Residents are absurdly cheap labor, working long hours, and taking care of folks those individuals the public most wants cared for with their dollars, the one's without fancy private doctors. If it were purely up to the taxpayers, they ought to want residency training to be extended, not shortened. There are few bargains in life -- residents are one of them. It's one of the few federally funded programs that generates far more value than is paid in -- it is not a money pit, but a fairly sound investment. There have been at times even been suggestions to expand this kind of training to other professions (law, dentistry), because it is actually quite a cheap, effective way to give services to the poor and needy.

 

[BlondeDocteur]

I also think (and hope!) that the working life of a fellowship-trained surgeon is greater than 20 years.

That being said, it is very amusing to ask the average person on the street how long doctors are "in school" for. Most don't know what a residency is.

 

[Blade28]

Agree with the above posts.

Even someone finishing training (long residency, fellowship, whatever) in their mid-30s can still be productive for another 25-30 years, minimum. And residents do indeed provide a very cheap source of valuable labor.

 

[fuzzyerin]

I think the public would be more appalled if they knew that people were awake caring for them and their loved ones for >24 hours without sleep.

I know personally my family now thinks medical training is crazy. Who wants someone to operate on them when they haven't slept in >24 hours? I've been there, doing the operations, but there's something insane about it.