Getting into Medicine requires full commitment to lifelong learning. After completion in medical school and post-graduate training, graduates undergo residency in hospitals to do specialized training. From internship to residency, these individuals have worked long hours that make them somehow immune against sleepless nights as they go along this path.
Video game developers may need to stay up for 16 hours; truck drivers may work upto 70 hours a week; managers and executives usually do upto 72 hours a week. What about the doctors, you ask? I’ve seen resident doctors work upto 100 hours a week (maybe even more) while on training!
Well, guess what doctors! There’s a recent study showing not much of a difference on patient outcome between internists who are already practicing for 10 years versus those who recently graduated with fully and partially exposure to the reformed residency work hours (restricted to 80 hours a week) in the US.
The study though specified that they only chose General Internists and their admitted patients during 2000-2012. Their point of comparison revolved around the following: 1) 30-day mortality rates (how much of their patients died within 30 days of admission), 2) 30-day readmission rates (how much of their discharged patients came back to be admitted again within 30 days), and lastly 3) cost of inpatient spending (how much is the total amount of their patients’ hospital bill).
Since there is no chance of having similar participants/patients, the researchers considered that too. They compared in their statistical analyses the differences in patient demographics (age, gender, and ethnicity are examples) and pre-existing conditions (chronic diseases present in the patient prior to the day of their admission during the study).
Anupam Jena, one of the authors, says that “less cumulative clinical exposure can be offset by greater consolidation of clinical knowledge mediated by reductions in fatigue and increased teaching by residency programs”. Now, that’s something to consider!
Also, not to be missed out here is that hospital care is not solely done by the attending physician. The care is provided by a multi-disciplinary team including nurses, nurse aids, pharmacists, medical technologists, radiologists, and any healthcare professional that handles the patient too. The researchers are completely aware of this factor that influences patient outcome and costs of care, hence, they muted the effects of the team.
This study now shows evidence to answer the theory of trainees being less prepared for private practice when they take reduced shift hours during residency.
If you want to read the whole study, you can get the paper here.