ccrystey said:
I'm arguing that the system needs to be changed because they are
over-worked. I think this could cause them to be too exhausted and put
their health and the health of the patients at risk. I would really appreciate your opinions on this topic. Could you please help me with this paper by answering some of my questions?
😕
1. what is the current state of a residency program?
2. what do you think of it (from your experience)(pros and
cons/consequences)?
3. what do you think should be changed/improved?
4. what do you think of my proposal of shortening shift hours by:
- extending medical school to a 4 years or 5 years program, so people can
choose to spread out their time of clinical rotations?
- extending residency an extra year (would this cause a bottle neck effect?)
- accepting more foreign physicians/ medical professionals to relieve
shortages in the medical field
5. why do you think hasn't any of these changes or any change been made?
The following is from the ACP Impact October 2004 E-newsletter. I happened to run across this, and I remembered your post from several days ago. I, too, was unaware that the 80 hr/week "restrictions" were also in place for students doing their clinical rotations.
deb
Update on Student Work Hours
Most medical students are aware of the major changes in work-hour restrictions that affect the 98,000 interns and residents in teaching hospitals across the U.S. But did you know that similar rules are now in place to protect medical students?
Since the resident work-hour restrictions were implemented in July 2003, several student organizations, including the Medical Student Section of the American Medical Association (AMA-MSS), the American Medical Student Association (AMSA), and the ACP Council of Student Members (CSM) voiced concerns that at certain medical centers, students are forced to pick up additional "scutwork" as their post-call residents rush to leave the hospital. Though not intended when the residency work hours were implemented, such a concern regarding the negative impact on medical student education must be addressed.
Realizing this potential problem, in February 2004, the Liaison Committee of Medical Education (LCME), the accrediting authority sponsored by the Association of American Medical Colleges and the American Medical Association, which regulates medical education programs leading to the MD degree in U.S. and Canadian medical schools, created similar work-hour restrictions for medical students in education and clinical training. The move was brought about in part by a resolution passed by the AMA-MSS in 2003. With the concerns voiced by the AMA-MSS and AMSA, the LCME subsequently issued new recommendations which state that medical schools should "give careful attention to the impact on students of the amount of work required, including the frequency of examinations and their scheduling." In addition to monitoring the amount of classroom time and examination frequency, "attention should be paid to the hours medical students work during the clinical years and the educational value of their clinical activities. Student duty hours should take into account the effects of fatigue and sleep deprivation on learning and patient care. In general, medical students should not be required to work longer hours than residents."
However, the recommendation did not state how schools were to track these hours, nor did it address how medical schools would be judged to be compliant with the new recommendations. To monitor the effects of both the resident work-hour restrictions on students as well as the new LCME guidelines for students, the Hourswatch.org Web site has been established by the Committee of Interns & Residents (CIR) and AMSA. It is a forum for both residents and medical students to share their experiences relating to work hours, both negative and positive.
Recently, AMSA also completed a separate online survey to measure the impact of the resident restrictions on medical students' education and training. Although the results are still being compiled and analyzed, AMSA hopes to share these results soon through their Web site. Preliminary findings show that student job responsibilities clearly have been affected by resident work-hour limits.
As the results of these studies become available, representatives of the CSM plan to write to the Clerkship Directors of Internal Medicine (CDIM) to take proactive measures to address these issues. A major concern of the CSM is that students, residents, and attendings are unaware of the work-hour restrictions on students. Although student work-hour restrictions may not be a problem in many academic medical centers, we want to remind the clerkship directors that they can help by educating attendings and housestaff about these new guidelines and continuing to place emphasis on quality of medical education. For programs that do have problems with student work-hours, an internal monitoring program may help these clerkship directors monitor the approximate number of hours that students work on a weekly or monthly basis to prevent potential abuses. Furthermore, it is essential to track whether these hours are devoted to patient care and education versus non-educational activities (i.e., scutwork). The CSM will advocate that the CDIM establish confidential channels through which students can voice concerns without fear of retaliation or negative impact on their evaluations or grades.
In working with the CDIM, the CSM's goal is to ensure that each medical student has the most productive and educational experience possible during their internal medicine clerkships. Please feel free to contact your regional CSM representative if you have any concerns. A list of the CSM delegates and their regions can be found here.
Erin Dunnigan
Council of Student Members Representative, North Central Region
Ohio State University College of Medicine, 2006
E-mail:
[email protected]
