July 2, 1997

Is Residency Training Really Harmful?-Reply

Author Affiliations

Medical College of Wisconsin Milwaukee

JAMA. 1997;278(1):22-23. doi:10.1001/jama.1997.03550010036027

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To the Editor.  —The intention of my article was to call attention to the human costs of today's medical training system both for the patient and the physician and to suggest ways to improve that system as health care reform evolves. It was based on Duncan's book, in which he researched and documented postgraduate medical education in the United States in the 1990s. Duncan surveyed a variety of hospitals and specialties, and he cited specific references to support his observations. I believe he met the scientific muster that our profession demands in research. He relays his conversations with many leaders in medical education, including Bertrand Bell, MD, and John Stobo, MD. Both of these distinguished physicians and Duncan agreed that the current system is costly to patients, residents, and payors and is in need of change. I feel as though I am in good company.The 3 main points remain. First, long hours