[the_d3f4ult]

Fair point. There's some data showing patient outcomes are worse when managed by overworked residents-in-training, but I think you're referring to outcomes post-residency. i.e. Physicians should squeeze as much training as possible into the allotted years. This is reasonable, especially for surgical specialties where procedural reps are a commodity for trainees.

I'd be more open to this line of reasoning if physician's salaries had kept pace with inflation over the last 30 years and if if we hadn't tacitly accepted a much, much lower standard of training in the form of DNPs, CRNAs and PAs who are now practicing independently in a lot of regions. You can't demand that people make extraordinary sacrifices without extraordinary compensation.

For contrast, most European countries have a much longer post-residency training process that is more humane. Caveat being that students enter medical school directly from high school and don't have student loans.

It's also worth pointing out that in the US a LOT of those 100 hours are not spent in direct patient care. They're spent doing chores ('scut') that are not directly tied to patient care. Think: Calling insurance companies for prior authorization for your supervisor or filling out FMLA paperwork for one of your supervisors' patients. As a resident you don't have the ability to say "no" to these tasks.

[mlyle]

> i.e. Physicians should squeeze as much training as possible into the allotted years. This is reasonable, especially for surgical specialties where procedural reps are a commodity for trainees.

It's mixed, though. We don't know how much "squeezing as much training" helps or hinders future performance. We do know that sleep debt hurts retention of new knowledge and skills.

So I'm not positive whether "50% more training, but with not enough sleep during most of the interval" will result in better outcomes.

> I'd be more open to this line of reasoning if physician's salaries had kept pace with inflation over the last 30 years

Doctors in the US are artificially scarce and artificially expensive compared to the rest of the world. The artificial scarcity of residencies also contributes to the unusually harsh residency work conditions.

[marbro]

Doctors in the United States are paid more than doctors in Norway and Switzerland even though those countries are richer and our doctors aren't better.