Resident nap study should not be used to make case for longer hours

LETTER — Posted Aug. 14, 2006

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I became increasingly disappointed as I read the AMNews article on a study that concluded that naps improve resident's alertness on call. As a recent graduate from a primary care residency program, it strains credulity that the reality of contemporary residency training is seemingly unrecognized (Article, July 17).

The lead author of this study speculated that the 30-hour on-call limit could be extended if naps are included. However, I believe the conclusions of this study lend uncompromising support to the continuing improvement of resident working hours.

Many who demand extension of the working hours (i.e. a return to the past) suggest such hours are a necessity for patient care. This is disingenuous at best. Working 80 or more hours a week is an abnormal endeavor that results in an inefficient and dangerous decline in functional acuity.

Many of those who suggest otherwise have lost touch with the reality of residency as it is today. The increasing numbers of complex patients with multiple comorbidities and the concomitant avalanche of paperwork alone progressively eclipse the core purpose of residency.

Residency should be perceived as a protected, unique period dedicated to clinical education and transformation of medical school graduates into humane and compassionate physicians. It must not be construed as an opportunity for indentured abuse of trainee physicians.

Scott A. Weinstein, MD, PhD, Bayside, N.Y.

Note: This item originally appeared at http://www.ama-assn.org/amednews/2006/08/14/edlt0814.htm.

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