Sunday, June 07, 2009

Kids these Days....
If this post sounds like the old "uphill both ways to the hospital barefoot" rant, well it is.

At the end of this month the second group of surgery residents (assuming a 5 year term) will graduate that have trained exclusively under the ACGME mandated work hour limits. As few programs extend beyond seven years, after next year there will probably not be a current surgery resident that was trained in the "bad old days".

Along the same line, this will be the third ob/gyn and fourth IM/FP/PEDS class to graduate.

A conversation with a gynecologist colleague of mine at lunch the other day was revealing. She asked me to compare the residents I worked with in my recent fellowship the those that I worked with when I was a resident. She and I finished training about the same time. She has a very successful practice but wants to spend more time with her children.

I told her that while the intelligence of the residents were the same, the motivation was not as "intense" as I remember mine and my compatriots to be. Their day was not over when the work was done, but when the night float shows up. Work hours nonwithstanding the "accountability factor" was lower. So while you had a more well-rested residents, you also had, for the most part, less dedicated ones.

Anyway, this conversation came up in the context of her hiring a new associate. The physician she is in negotiaions with comes from a well-regarded university program. My colleague was amazed that the soon to be former chief resident was unpleasantly surprised that they would be expected to work on their post-call day. Something that they had never had to do. Ever.

So if you think hiring a new associate will cut down on your hours, think again. But in a few years we will all be shocked, shocked, that our new associates will never have taken call without dedicatednap time.

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