"Don't go to the hospital in July." That's the prevailing public perception, since that's when new resident-physicians begin their hospital training. And indeed, there have been studies from Australia and England showing a higher rate of death and adverse events during this time. But what about in the United States? Recent data isn't so conclusive. A piece from American Medical News points to a recent study from the Journal of the American ...

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The restrictions on resident work-hours arguably most impacts the field of surgery. I understand that fatigue increases the risk of medical errors, but in this excellent post, Jeffrey Parks notes some benefits of being immersed in the hospital. Something is lost as doctors are scuttled out of the hospital when the 81st hour starts. Dr. Parks notes that "there's more to being a doctor/surgeon than just learning how to fix a ...

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Much has been made of fatigue increasing the number of medical errors doctors make. But what about other factors, like emotional stress? That's a little-reported issue that Pauline Chen addresses in her recent New York Times column. In residency, some doctors-in-training have to care for small children, among other life issues. As Dr. Chen notes, "whenever one of us experienced additional stress apart from our work, the house of ...

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Controversy persists about limiting the work hours of resident physicians. No where is it more prevalent than in surgery, where proficiency depends on the number of times a trainee physician performs a procedure. In a recent study from the Journal of the American College of Surgeons, 43 percent of surgical residents want to work more than the allotted 80 hours per week, and 41 percent felt the work-hour restrictions ...

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Here's an excerpt from a lovely little book by John D. Barrow called One Hundred Essential Things You Didn't Know You Didn't Know; Math Explains the World. This selection has a great lesson about statistical inference. The chapter is entitled, "Why does the other queue always move faster?" You will have noticed that when you join a queue at the airport or the post office, the other queues always seem to ...

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It's no secret that, in an attempt to increase the pay of primary care doctors, Medicare is going to run in serious resistance from the specialists. In this article from Bloomberg, for example, we're seeing backlash from cardiologists. What caught my attention was how cardiologists in residency programs may now harbor resentment against primary care doctors in training. Consider what Ted Epperly, president of the American Academy of Family ...

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by Chris Emery, Contributing Writer, MedPage Today Reductions in resident physician work-hours at teaching hospitals in 2003 were associated with an increase in complications related to surgery to repair hip fractures, a new study found. medpage-today The rates of pneumonia, hematoma, renal complications, and blood transfusions associated with hip surgery rose disproportionally at teaching hospitals compared to other hospitals after resident ...

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by Larry Husten, Ph.D. A recent hearing of the Senate Aging Committee on continuing medical education (CME) should scare anyone who might need to see a doctor in the next few years. But you don't need to be a Washington policy wonk to discover that there's a huge problem with CME. Just walk into the lobby of any major downtown hotel when a large medical conference is in town and you will ...

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Most medical students don't take classes on how to discuss informed consent, that is, talking about the risks and benefits of a medical procedure with a patient. Pauline Chen remembers such conversations, where she "bumbled through each consent on [her] own, picking up certain phrases and dropping others through a sometimes painful and often awkward process of trial and error." That's often the case, as "young doctors rarely have formal mentorship ...

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According to the Journal of the American Medical Association, only 2 percent of medical students are entering primary care internal medicine. A fourth year medical student gives some reasons why in a Baltimore Sun op-ed:

Like many medical students, I proudly wear Obama T-shirts and yearn to reform medicine. While watching the president speak, I envision myself working in primary care, on the vanguard of health care reform. Then, a little later, reality ...

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