This article has a misinformed title – the article is not about interns, it is about medical students – Your Intern Today Is Both Sleepy and Bored. Feel Better?
In a recent survey by the American Medical Association, one in four students said lack of sleep had put them in physical danger and one in six reported having or nearly having a car accident because of sleep deprivation. Two-thirds said fatigue might have affected their learning.
As a result, medical schools and the bodies that set policy for medical education are debating whether medical students should have strict guidelines similar to those that limit the hours medical residents can work.
Many schools have started to monitor how much time students spend in the hospital and what they do while they are there, and some have instituted formal policies.
At the University of Chicago’s Pritzker School of Medicine, policies enacted last year require that third-year students’ on-call duties end at midnight, so they have time to do patient write-ups, discuss their observations with residents and still get home to study and sleep before morning rounds.
“There was a lot of anxiety on the part of students as to when they could go,” said Dr. Holly Humphrey, dean for medical education at Pritzker.
Faculty members were also confused about when to send students home, and sometimes had trouble keeping track of them, resulting in “dramatic stories of students being in the operating room and no one realizing how long the students had actually been in the hospital,” Dr. Humphrey said.
The rules also recommend against assigning new patients to students after 10 p.m., and they also grant holidays off.
Medical students on 3rd and 4th year rotations have few rules. The challenge in developing rules is to balance their educational opportunities with time off.
On internal medicine at my institution, we do a good job of making the students job humane. They have the same rules as the interns! We give them all weekends off (unless the team is on call).
When you talk to interns from other medical schools, you still sometimes hear “horror stories”.
Developing guidelines for how we treat medical students makes sense – and is long overdue. I only urge that we give the students some flexibility so that they can make intelligent choices in balancing educational opportunities.
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1 Response to How we treat medical students
Juan Llovera
July 1st, 2009 at 9:07 pm
Well, I’m a medical student in Venezuela… Mostly our shifts end at midnight, but some clerkships ask for us to stay at the ER after that. I’m very frustrated because as the lack of residents in hospitals continues to grow, they are using us to work harder than the should ask us for. The worst part is that we can’t even complain, because there isn’t any rule we can use in our defense and we are not paid for our WORK!