My opinion: Ok, so here's an idea for why this happens: many patients don't want residents treating them. Though I have heard horror stories about residents messing up, if they don't get the experience they need, then there won't be anyone experienced in the future, especially with the doctor shortage. Of course, to say that this is the only thing going on would be an oversimplification. To add to this, I'm not so sure that the 80 our work week for residents is a serious problem. I've known doctors who abhor the decrease in hours, although they might envy the students a little, OR they think that they were better trained because they worked longer hours. The work week was decreased to ensure that doctors wouldn't become sleep-deprived and make more mistakes. So to give the residents more experience without making them sleep deprived, should residencies take an extra year or two? Or are the older doctors exaggerating this problem? What if doctors who aren't alive anymore saw the same thing in residents who are now our experienced doctors? Feel free to comment.
Are Today’s Surgical Graduates Prepared for ‘Real World’ Practice?
Surgeons Discuss Preparedness of Today’s General Surgeon Trainees in Light of Duty Restrictions, Narrowing Specialty Focus
When David M. Mahvi, MD, finished his residency in general surgery in the mid-1980s, he went into practice feeling confident about the skills he had gained in training and he felt well prepared to perform surgery and care for patients. However, established surgeons today have a sense that the present generation of surgeons-in-training is not ready to assume autonomy and responsibility for patients at the end of their training.
“By the time I was done, I had done a lot of stuff autonomously: I’d managed people in the OR [operating room], I’d managed trauma and I left my training feeling like I was competent, that I could go off and do surgery,” said Dr. Mahvi, professor of surgery, Northwestern University-Feinberg School of Medicine, Northwestern Memorial Hospital in Chicago. “The first couple of years of practice were pretty scary, but I didn’t feel like I didn’t know what I was doing.”
But Dr. Mahvi and other surgeons believe that today’s residents don’t feel quite so secure and, in fact, are not ready to take up the scalpel.
“They’ve dealt with this by doing fellowships, mostly in general surgery, a basic GI [gastrointestinal] surgery, which to me is a warning sign that we are not adequately preparing people,” said Dr. Mahvi. “We need to do something different in the way we are training people so that when they leave [training], they feel comfortable doing surgery.”
Part of the reason for this lack of competence and confidence is the lack of experience that new surgeons obtain in residency. The duty-hour restrictions that came into effect in 2003 and capped residents’ workweek at 80 hours are not the only factor contributing to this problem, but they certainly play a role.