Rethinking Medical Training — The Critical Work Ahead

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Abstract
What physicians do on a daily basis has evolved considerably in the past quarter-century, but the format of postgraduate medical training has changed relatively little. When we trained in internal medicine in the 1970s, our clinical rotations included every-second-or-third-night on-call schedules. At that time, completing all the tasks expected of a trainee routinely required 100 hours of work a week or more. Although the duty hours of house-staff trainees in internal medicine have decreased during the past 25 years, they remain substantial. Moreover, many of the other building blocks of medical training — work rounds, attending rounds, specialty conferences, and . . .

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