0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Editorial |

Residency Training in the Modern Era:  The Pipe Dream of Less Time to Learn More, Care Better, and Be More Professional

Patrick G. O’Malley, MD, MPH; Janardan D. Khandekar, MD; Robert A. Phillips, MD, PhD
Arch Intern Med. 2005;165(22):2561-2562. doi:10.1001/archinte.165.22.2561.
Text Size: A A A
Published online

Extract

Anyone who teaches and learns internal medicine understands the many challenges faced in accomplishing the enormous agenda required to mold a trainee into an independent practitioner capable of comforting and healing effectively. Perhaps the most recent salient challenge is that imposed by the new Residency Review Committee work-hour restrictions. That is, in the midst of an ever increasingly complex knowledge base and system of care with ever increasing pressures on accountability for both safety and performance, there is now less time to accomplish these burgeoning goals. The 80–hour per week and the 30–hour per shift work-hour restrictions are not based on strong evidence that they will result in better learner- and patient-centered outcomes. They are based on observational data that work hours correlate with medical errors,1,2 a few highly publicized medical malpractice cases implicating work hours as a root cause, and the general face validity for the concept that tired physicians are less effective learners and practitioners of medicine. Some research indicates that the work-hour restrictions decreased serious medical errors in intensive care units and improved sleep and attentional failure rates among trainees.3,4 However, it is still largely unclear what impact this policy is having on the various affected parties (patients, residents, and teachers), and the possibility of unintended consequences is always present even with the best intentions.5

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

Correspondence

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Web of Science® Times Cited: 7

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Collections
PubMed Articles
Jobs
brightcove.createExperiences();