I read with interest the article, On Young Doctors and Long Work Days, that appeared in the New York Times yesterday. It examines the issue of resident work hours in an interview with Thomas J. Nasca, MD, chief executive for the Accreditation Council for Graduate Medical Education (ACGME). The ACGME recently issued a letter endorsing a systematic review of resident duty hours with the goal of creating appropriate standards that recognize the challenges presented in the training of residents.
What I found more interesting was browsing through the 113 comments left on the NY Times Blog about the article. Lots of challenges and issues.
Is current orthopaedic residency training better or worse? Is it more safe now that residents have 80 hour work weeks? More importantly are residents competent at the end of their training? How long does it take an orthopaedic resident to acquire the skills, knowledge, attitudes and judgement necessary to practice orthopaedic surgery safely, efficiently, and cost effectively.
We will be starting a trial of a competency based curriculum in orthopaedics within our Division at the University of Toronto. In preparing for a meeting I came across the following file which is an impressive body of work that helps put the challenges and issues into perspective.