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August 26, 1998

Mistreatment and Maladaptations During Medical Internship

JAMA. 1998;280(8):699-700. doi:10-1001/pubs.JAMA-ISSN-0098-7484-280-8-jbk0826

To the Editor.—Dr Daugherty and colleagues1 deserve credit for exposing the problems with residency working conditions. Although their data are from more than 5 years ago, we believe that mistreatment persists. As resident leaders, many of our colleagues have complained to us about intimidation, overwork, and even discrimination. The hierarchy of medicine unfortunately allows some people to abuse power. In addition, the financial constraints imposed by managed care and decreased reimbursement often shift the delicate balance of education vs service. Too often, the scale is tipped to service aspects of residency at the expense of education. The interest in resident unions may be a desire by residents to rebalance the mission of residency.

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