Volume 197 - Issue 2
Does it take too long to become a doctor?
Author: David Ku
Med J Aust 2012; 197 (2): 89. || doi: 10.5694/mja12.10805
Published online: 16 July 2012
Published online: 16 July 2012
To the Editor: The United States medical education system is not a valid comparator in arguing for the shortening of training times for specialist doctors in Australia,1 whose training experience is already less than desirable. I was recently a medical observer at a major US training hospital, and there are significant differences in specialist training between the two countries.
The Australian Medical Association Safe Hours campaign ...
To the Editor: The United States medical education system is not a valid comparator in arguing for the shortening of training times for specialist doctors in Australia,1 whose training experience is already less than desirable. I was recently a medical observer at a major US training hospital, and there are significant differences in specialist training between the two countries.
The Australian Medical Association Safe Hours campaign has limited clinical hours to 38 hours a week, with 5–6 weeks of leave. Any hours worked over the set 38 clinical hours are counted as overtime, which puts a significant financial strain on hospitals. That trainees could conceivably work all their hours over 4 days and never have to work on a weekend clearly does not realistically reflect the life of a fully trained doctor. With the number of training positions increasing disproportionately to population and hospital growth, the modern trainee’s experience has been significantly diluted.
In contrast, the length of shifts in the US training scheme has recently been “relaxed” to 30 hours, with no stated limit on the weekly hours worked (but this is usually 70–80 hours per week); trainees have only 2 weeks of leave per year and an annual salary of US$40 000–50 000 (compared with a base wage of around A$65 000 for residents in Australia). This is almost double the amount of training time per year compared with Australia. When the US residents asked about our training system, I was torn with pride, guilt, and quite a bit of concern.
Australia has maintained a high standard of medical care because of our past stringent training programs, but this is threatened by financial pressures on hospitals, and the supposedly “safe” 4-day working week. This dilution of experience and work ethic is concerning. I hope changes will be made so that we can have as much faith in our students as we did in our teachers.
Competing interests
No relevant disclosures.
References
- McNamara S. Does it take too long to become a doctor [Part 1]? Med J Aust 2012; 196: 528-530. 0_IEFFHIHD