Holiday Treats

Here’s something for the students coming in January – some pictures from around campus!

Also, if you’re a med student and you haven’t already registered at Medscape, do it now (it’s free!). In the Differential, there’s an article on the December 2nd IOM report that has sparked a hot debate in the medical community as well as in the comments section – it’s definitely worth a read.

I read this article in the NY Times article a few weeks ago and while it raises several important points, I can’t help but notice a tone similar to some of the more contentious comments in the aforementioned article. There’s a sense of ‘Quit your whining! Back in the olden days, we worked a hundred and thirty hours a week (and had to walk uphill to the hospital both ways!) and we learned tons so deal with it!’. I was especially surprised to find that sentiment in an article by Dr. Pauline W. Chen, who has written several pieces for the Times that seem to have a bit more sympathy for the plight of the doctor-in-training. In many of the responses criticizing the IOM report that I’ve read, there seems to be not just a little bit of braggadocio and arrogance; while arguing that more hours means more experience, they’re also basically saying ‘if I was able to get through my grueling residency, sleepwalking when I had to, then everyone else should be able to do it too.’ I’m not sure if that’s a valid argument or justification. It’s one thing to take pride in one’s work ethic and to seek knowledge and experience to the point of working so much that one barely has time to do anything but sleep, shower and return to the hospital but at what point do such things become harmful or dangerous?

Since I’m still a lowly MS I (who will hopefully [Please, God!] be an MS II come January), I can’t really say whether or not capping a resident’s week at 80 hours is the best choice (especially since it seems to have been an arbitrary decision). I do know that every med student learns basic neuroscience and anyone who’s been through neuroscience can tell you that sleep is absolutely essential for proper brain function. The less sleep one gets, the more mistakes one makes. When one’s job is dealing with other people’s lives, mistakes and errors caused by lack of sleep can be fatal. So while Dr. Zombie who’s been on a 36 hour shift in a 110 hour week may get to see dozens more patients than the “lazy” resident who stopped after 16 hours for a nap, how many more mistakes has Dr. Zombie made? But who knows? Maybe when I get to residency, I’ll feel just like Dr. Chen and I won’t want to trade all my experiences for a few extra hours of shut-eye. Then again, I don’t drink coffee and I don’t want to kill somebody’s baby because I was too sleep-deprived to properly read their chart or some nonsense like that.

Back when I was training as an EMT, our instructors always told us that before we could approach a situation to care for a patient, we needed to make sure that it was safe for us to do so. If I’m so tired I can barely stand, how can it be safe for me to treat a patient? Even if I’ve got a chance to witness a procedure so rare House wouldn’t be able to perform it, if I can’t even keep my eyes open, what good is it? But, as Dr. Chen argues, it isn’t just about sleep. It’s about how residency programs are structured, how much support residents receive and how much responsibility rests on their shoulders. I guess I agree with the idea that it’s going to take more than a workweek restriction to improve conditions for residents and care for their patients. But there’s got to be a better way to train doctors than working them like dogs and not allowing them sufficient time to rest.  In any case, I’d love to hear from any current residents who support the decision to scale back residents’ work weeks, particularly why they think it will be beneficial rather than detrimental to their training.

On a lighter note, if you don’t know what to get your favorite med student (or anatomist) for Christmas, here’s an idea: plush organs from i heart guts! How about this disgruntled looking pancreas? You can get them with cute t-shirts too!

I hope everyone has a happy holiday (whatever you celebrate) and a wonderful new year! Back in January…

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