Residency Overwork
Authors: Merle Myerson
Journal: Annals of Internal Medicine (1996)

Letters15 May 1996Residency OverworkMerle Myerson, MD, EdDMerle Myerson, MD, EdDDuke University Medical Center; Durham, NC 27710Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-124-10-199605150-00032 SectionsAboutVisual AbstractPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:As a third-year resident in internal medicine at Duke University Medical Center, I disagree personally, empirically, and theoretically with the position taken in Dr. Green's recent article [1].I feel that working long hours facilitates both optimal patient care and educational experience by allowing the house officer to see the full effect of his or her interventions. By following a patient through the critical initial hours, a resident is uniquely able to reevaluate the patient.Studies have supported my experience. Petersen and colleagues [2] suggested that a fatigued intern with detailed knowledge of a patient may provide better care than a well-rested intern who is cross-covering. Lofgren and colleagues [3] showed that hospital admission by a cross-covering resident results in a significant increase in the total number of laboratory tests and a trend toward longer hospital stay and the further occurrence of fever. Thus, although Dr. Green touches on continuity of care, his review is incomplete.I also question Dr. Green's contention that residency overwork interferes with the promotion of virtue. What about the virtue of commitment, dedication, and perseverance? Each of these virtues might be learned or reinforced through an arduous clinical schedule. At Duke University Medical Center, we have accepted the challenge of virtuous patient care and live up to the basic tenet of our former chair, Eugene Stead, who stated: “The sick never inconvenience the well.”My fellow housestaff and I chose a system that offers the best in patient care and medical education; we did not merely “consent” to it. As we reform medical training and change to a system that acknowledges some virtues and ignores others, we may create a future that provides medical shift workers rather than dedicated physicians.References1. Green MJ. What (if anything) is wrong with residency overwork? Ann Intern Med. 1995; 123:512-7. Google Scholar2. Petersen LA, Brennan TA, O'Neill AC, Cook EF, Lee TH. Does house-staff discontinuity of care increase the risk of preventable adverse events? Ann Intern Med. 1994; 121:866-72. Google Scholar3. Lofgren RP, Gottlieb D, Williams RA, Rich EC. Post-call transfer of resident responsibility: its effect on patient care. J Gen Intern Med. 1990; 5:501-5. Google Scholar Comments0 CommentsSign In to Submit A Comment Author, Article, and Disclosure InformationAffiliations: Duke University Medical Center; Durham, NC 27710 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByThe Educational Impact of ACGME Limits on Resident and Fellow Duty Hours: A Pre???Post Survey StudyPerceived Impact of Resident Work Hour Limitations on Medical Student Clerkships: A Survey Study 15 May 1996Volume 124, Issue 10Page: 932KeywordsFeversForecastingLaboratory testsMedical educationPatientsResidencyTouch Issue Published: 15 May 1996 CopyrightCopyright © 1996 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...