A dose of reality in residency training

• Previous message: A dose of reality in residency training
• Next message: A dose of reality in residency training
• Messages sorted by: [ date ] [ thread ] [ subject ] [ author ]

IMHO both points of view are true and valid. I think Mike's most  
important point, and the one where there is the greatest  
irreconcilable tension between the two "truths" is in #3. No  
modification with models or anything else will be able to give the  
crucial witnessing of how a patient progresses over the first 24 - 48  
hours in response to your different interventions, in a real time  
minute to minute basis. In Trauma Surgery where the initial treating  
physician is still the team leader during the critical care phase,  
that is so often the most important time. And one in which the art of  
medicine is learned.

Rob Smith

On May 7, 2009, at 9:14 PM, Gross, Ronald wrote:

> Hmmmmm.  Seems to me that you did a really nice job of restating my  
> posts, Mike.  Thanks.  Only, I never said I was right - I just said  
> we need to figure out who IS, and how we can build a better mouse  
> trap, 'cause the one we have at the moment isn't working.
>
> Take care,
> Ron
>
>
> -----Original Message-----
> From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org 
> ] On Behalf Of Sise, Mike MD
> Sent: Thursday, May 07, 2009 8:32 PM
> To: trauma-list at trauma.org
> Subject: A dose of reality in residency training
>
> Time for a reality check:
>
>
> 1.      "Old school" every other night on call was horrible and  
> ruined many marriages and careers - errors were common and frequent.  
> During that time in my life, my wife's favorite saying was that the  
> world's biggest lie is that it will be better next year.
> 2.      It takes a very large amount of clinical experience to  
> become a surgeon - a critical mass of sick patients, operative  
> experience, mentored leadership time, and senior decision making  
> responsibility
> 3.      Five years of 80 hours or less per week, truncated by  
> mandatory time away, lack of longitudinal responsibility may not be  
> long enough to accomplish the independent status required of  
> graduates in the US system
> 4.      The European and Great Britain model of extended training  
> after residency is probably out of the question in the US where  
> medical school is not free and most interns already have $200,000 or  
> more debt and don't get paid well as residents. Who will ask our new  
> young surgeons to live with their debt another 2 to 4 years, maybe  
> longer?
> 5.      Further work restrictions will demand of us a complete  
> redesign of training programs and the expectations of graduate  
> surgeons. Will we have a "1st Officer" status like the airlines  
> where our young surgeons don't have primary operative responsibility  
> for a set number of years and operative volume after residency? Work  
> force shortages make that seem unlikely and yet young surgeons may  
> be forced to do something like that on their own out of sheer  
> necessity.
> 6.      Time to stop fighting over who's right and who's wrong over  
> this issue. The old days are gone for good and any of us who trained  
> that way and complain about the new graduates are not making it any  
> more likely that we will find an effective new way to train the next  
> generation of surgeons. They are just as dedicated and committed as  
> we were and they deserve our unqualified support. They need us to  
> help them learn what we did - how to be there for our patients in  
> hours of desperate need when there is much at stake and decisive  
> action is required.
>
> Mike Sise, San Diego
>
>
>
> "Scripps Information Security"
> ------------------------------------------------------------------------------
> This e-mail and any files transmitted with it may contain privileged  
> and confidential information and are intended solely for the use of  
> the individual or entity to which they are addressed. If you are not  
> the intended recipient or the person responsible for delivering the  
> e-mail to the intended recipient, you are hereby notified that any  
> dissemination or copying of this e-mail or any of its attachment(s)  
> is strictly prohibited. If you have received this e-mail in error,  
> please immediately notify the sending individual or entity by e-mail  
> and permanently delete the original e-mail and attachment(s) from  
> your computer system. Thank you for your cooperation.
>
>
> = 
> = 
> = 
> = 
> = 
> = 
> = 
> = 
> ======================================================================
> --
> trauma-list : TRAUMA.ORG
> To change your settings or unsubscribe visit:
> http://www.trauma.org/index.php?/community/
>
> ----------------------------------------------------------------------
> CONFIDENTIALITY NOTICE: This email communication and any attachments  
> may contain confidential and privileged information for the use of  
> the designated recipients named above. If you are not the intended  
> recipient, you are hereby notified that you have received this  
> communication in error and that any review, disclosure,  
> dissemination, distribution or copying of it or its contents is  
> prohibited. If you have received this communication in error, please  
> reply to the sender immediately or by telephone at (413) 794-0000  
> and destroy all copies of this communication and any attachments.  
> For further information regarding Baystate Health's privacy policy,  
> please visit our Internet web site at http://www.baystatehealth.com.
> --
> trauma-list : TRAUMA.ORG
> To change your settings or unsubscribe visit:
> http://www.trauma.org/index.php?/community/

• Previous message: A dose of reality in residency training
• Next message: A dose of reality in residency training
• Messages sorted by: [ date ] [ thread ] [ subject ] [ author ]