First of all, you need to see as much pathology as you can. Actually see the disease process from start to finish in the ER/Clinic.
Secondly, I think it dispels the myth of the "part time" doctor. The guy/gal who like to say, "I'm a doctor" but isn't dedicated to the time consuming review of organ systems, pathology, biochemistry and multiple other diagnostic and treatment modalities that are currently being used and future developments.
Thirdly I think that being in a hospital for hour upon hour makes you comfortable in your work environment and desensitizes you to some of the most awful things you can imagine. It helps you learn how to cope and in some respects how you don't cope with having someone's life in your hands. LITERALLY...
Every time a mother brings her child in with an astma attack, grandma comes in with chest pain, dad hit his head and is not waking up, Chato and Willy come in with sucking chest wounds and guts hanging out.... young girls come in from car wrecks or just drunk kids puking their toe nails up... you have to prioritize what you've seen hundreds and maybe several hundred times to what your presented with...
only after hours and hours of sick kids over years will you get the weird "feeling" of a real sick kid.... or If you've ever heard REAL "whooping" cough, you know the difference between that and a croupy cough, or a partially obstructed airway from a peanut from a sick kid with epiglottitis.... and which ones make your sphincter tighten up no matter how little sleep you've had.
The hardest residencies aren't necessarily the ones with the least sleep, but they generally have the busiest hospitals and the more upper level residents busting the balls of the lower level residents in order for them to explain the presentation, differential diagnosis and current workup, treatment and statistics ... also to describe down to the biochemical level the disease process... otherwise any old joe could get a book out of the library and "fake" being a doctor as several have done in the past...
Heck even actors know all the right "words" but have no idea about the biochemistry behind the pathology and treatment. THAT's what medical school and residency do. You KNOW what to do and why you're doing it.
Of course I could be wrong and it just could be a way of killing people so that other doctors have a corpse in your closet or some other nefarious scheme to get a bunch of drug addicted speed freaks into medicine in order to kill people.....
I remember the first time a resident told me he couldn’t take call because the residency advocacy committee had decided that 24 hours was too long. I couldn’t believe what I was hearing. When I was a resident the immediate response would have been to show me the door. While I don’t believe in abusing a surgical resident I don’t think it is up to an “advocacy committee” to dictate resident training. The idea is to make a doctor not a union employee cranking bolts on a car. The most enduring lessons I ever learned were learned when I was under stress and nobody around to bail me out. Surgery is not a classroom acquired skill.
Of course I could be wrong and it just could be a way of killing people so that other doctors have a corpse in your closet or some other nefarious scheme to get a bunch of drug addicted speed freaks into medicine in order to kill people.....
However, I know how I get when I’m without sleep for 24 hours. Even with lots of caffine, I’m not hitting on all cylinders. Its hard for me to imagine going 2X that or more without sleep and being able to function effectively. Maybe you can do something rudimentary (like marching), but its hard to imagine being able to do something that’s mentally challenging—like diagnose a patient. I think I’m pretty typical in this respect, which is why most layman have a hard time understanding the nature of intern/resident training.
Of course, if a human being is trained right, they can do amazing things. If someone can hold up under these conditions, my hat is off to them. I can easily jog 5 miles at a time, but don’t think I’m tough enough to do that.
Actually it’s a nefarious way of forcing recent medical school graduates to provide below-cost care so that politicians can continue to buy people’s votes with various forms of free healthcare (Medicare, Medicaid, mandates to treat illegal aliens, and various other programs). The socialist hospital system in this country couldn’t possibly stay afloat without all this forced labor being provided at a tiny fraction of free-market cost.
And stumbling around a hospital in a sleep-deprived stupor for 4 years never made anybody a good doctor. Some manage to become good doctors anyway, but it’s in spite of, not because of the residencies. Plenty of solid medical research has shown the colossal negative effects of sleep deprivation on learning, reaction time, and physical and mental health. And a rather large study a couple of years back found that overworked residents were making a colossal number of potentially lethal errors each year, and that 90% of those errors were being caught by nurses before the patient was harmed. Funny how the nurses, with a tiny fraction of the “training” these doctors have, can detect so many doctors’ errors. Maybe its because most of them have gotten a healthy amount of sleep the night before.
I’ve been treated by so many utterly incompetent doctors over the years — all of whom had been through one of these purportedly wonderful, invaluable residency programs — that no one is ever going to convince me it serves any purpose but political vote buying with a side order of hazing. The long list of doctors — GPs, ER doctors, gastroenterologist — who spent TEN YEARS telling me and my mother that the intense and sudden pain I kept having right where the gall bladder is located (and that’s where I kept pointing, over and over and over again), often accompanied by vomiting, was 1) “just a little stomach bug — drink clear liquids and take some Tylenol”, 2) “a pre-ulcerous condition — just drink some Maalox every time it hurts” — that went on for years, as I downed literally gallons of Maalox, and 3) my favorite “honey, you just have a tummy-ache because your parents are fighting” — all went through these supposedly wonderful residencies. But somehow they still didn’t have an effing clue that sudden sharp pains, often accompanied by vomiting, that keep recurring in a patient who points right to her gall bladder every single time, just *might* be GALLSTONES. They finally figured it out when my common duct got completely blocked by stones, such that not a drop of bile could reach my stomach, causing it to back up from my liver into my bloodstream, turning me a lovely shade of yellow and rendering me unable to even keep down their favorite clear liquid, Gatorade. After my surgery (7 hours in surgery, 11 days in the hospital, because all the years of delay had made such a mess of things), the surgeon told me my liver had been in imminent danger of rupturing. In all likelihood, any nurse or first year medical student could have identified the problem as being in my gallbladder the first time I showed up in front of them and pointed at my gall bladder as I doubled over and winced in pain, especially after noting the lack of fever or any other symptoms and noting that my mother mentioned I’d vomited just before we arrived.