What I am saying, is that if we had an efficient training system in the U.S. where residents aren't abused and forced to do meaningless scutwork, with 60-hours per week of ACTUAL HANDS-ON TEACHING/LEARNING, this would easily prepare us for independent practice.
The reason why people say 80+ hours is required, is because residents are being exploited to do the scutwork that technicians/secretaries/mid-levels should be doing, AND ARE DOING in the real world.
You seem to have had a very bad medical school experience to be so embittered. I agree with you that a lot of medical education is not very educational. I disagree that residents are abused and treated inhumanely, at least not in most programs.
But let me enlighten you as to what really goes on in a private medical practice since you are NOT in the REAL WORLD as a medical student (probably at an academic medical center):
I do the admissions and discharges.
I do the billing.
I do the dressing changes and wound checks.
I do all the procedure, admission and discharge dictations.
I remove all the drains, sutures, staples.
I dictate all the notes and then proofread them.
I call the consults.
If a patient needs a stat test,
I am calling the lab, department, etc. to get it done (as I did yesterday for a patient in the pre-op area with angina; no one called Nuc Med to schedule the Persantine Stress test for me or called the cards consult.
I did it.) or am doing it (the test) myself.
I am talking to the families in the waiting room.
Large practices can employ mid-levels to do some of the above, but the vast majority of medical and surgical practices do no and thus, the attendings are doing all of this, without residents, midlevels, ward secretaries, etc.
Don't get me wrong...I have a great office staff and the hospital allied staff are very kind and helpful, but all of the above are considered my job. Do not assume that because you see PAs doing discharge summaries that residents don't need to know how to do them.
While you may see midlevels/techs/secretaries doing what you consider "scutwork", residents do need to do learn to do some of this because they cannot expect that they won't need those skills in practice. There is probably too much time wasted during residency doing these things, but IN THE REAL WORLD, attending physicians are doing this.
The ignorance is not your fault - its pretty characteristic of all of us who trained at academic medical centers, but please know that the vast majority of care in the US is not at these places and that most physicians don't have residents/mid-levels/secretaries and techs to do these things for them.
I am <honestly> interested in why you think that 60 hours per week is sufficient time to learn everything you need to know during residency, without lengthening residency. As noted above but another user, it is true that physicians coming out of training outside the US are much less prepared for practice and those that I've spoken to will readily admit that the expectations for new physicians is lower and that they take a few years post-residency to get up to speed. You can't have that in the US medical environment. In addition, are you postulating that ALL specialties could learn their craft in 60 hours? I would find it difficult to train surgical residents in that amount of time given the breadth of information and technical skills that need to be gained.
