In defense of long resident hours



In an article earlier this week, I took a potshot at the medical school establishment (silly me). In the article, I described research documenting that while most professors felt cutting back resident work hours would be good for students, most feared all kinds of negative clinical consequences. And I noted that the ambivalence seemed a bit odd.

Well, my critique stirred up at least one med school instructor, who wrote me a gracious letter explaining why he feels the old ways are best. I'll turn the podium over to Dr. Jerome Schnitt:

Only those who make their profession a true priority and a full-time commitment can perform the work at the quality necessary to meet the highest standards. This traditionally includes long hours of patient care. An old surgical resident's joke from the time when they worked 36 hours on and 12 off for a year at a time: "The only bad thing about the 36 on-12 off rotation is that you miss so many interesting cases when you are away." ...The profs at academic centers know well that to withstand the other pressures on life which detract from patient care, an MD has to prioritize patient care. That is best taught real-time.

While I have enormous admiration for the dedication and commitment articulated by leaders like Schnitt, I admit I still question whether you have to sacrifice your health and sanity--and worse, your ability to concentrate--by working such inhuman hours. Hey, I don't have anyone's life in my hands as an editor, but when my kids have kept me up late at night, you can see the results on the page, however subtly. I'd hate to think of what the equivalent would be when I'm being treated for critical health issues by a bone-tired intern at 3 a.m.

In any event, I welcome more input from my readers on this subject. And I celebrate the dedication that keeps physicians like Schnitt, and countless interns I'll never meet, working whatever hours their profession requires of them. I only hope there's a compromise possible, at some point in the near future, that fosters the dignity of the medical profession without increasing the risk to patients tired interns must treat. - Anne

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