MGH residents cut back hours, but with mixed feelings

When Lisa was a resident at MGH, some of her rotations had a healthy respect for the 80-hour limit, and some led to “bad weeks.”

We did the Malcolm Gladwell math on how long it would take Lisa to get her 10K hours and be an expert. It was the exact length of her residency program, 3 years of 80 hours a week. I could never understand, then, why surgeons needed 96 hours a week for 7 years. That’s well over 30K hours. No matter how complicated surgery is, the system is broken if it takes 30K hours to learn. For example, the article mentions that one of the ways they trimmed back the hours was by hiring “dozens of nurse practitioners to take over some of their work.” Um, if that was possible all along it’s inexcusable that they’ve only now taken that action.

The next thing about medicine that needs to be fixed is the standardized testing. Lisa has to take 8-hour tests every few years that have nothing to do with her chosen profession. To pass them, she has to cram useless facts into her head by studying 5-6 hours a day for ~6 weeks. The equivalent here of the nurse practitioner solution would be to make the subject matter of the tests topical, and confirm that the doctors that score well are doing so based on knowledge gained from their work, not memorized trivia.

I got fired up when someone mentions inefficiency in healthcare :-)