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Timothy B. McCall, MD

JAMA. 1989;261(6):909-910.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

Libby Zion's death¹ has changed residency training forever. The public is outraged that life-and-death decisions are made by residents working 36-hour shifts and 100-hour weeks. The medical community debates the merits of the present system, but the general public overwhelmingly disapproves of it and expects residency reform.

Residents, too, are demanding changes. The ill effects on their lives^2-5 are apparent, including depression, chronic exhaustion, dissatisfaction with personal life, substance abuse, cynicism, and marital problems. Increasingly, concern about life-style is leading talented individuals to forgo medical careers. Even prestigious residency programs are having difficulty attracting qualified applicants.⁴

Another spur to residency reform is the threat of malpractice liability. The public believes that long working hours and sleep deprivation harm patient care. Hospitals that continue to overwork residents can expect lawsuits alleging that tired residents provided poor care. Teaching hospitals could pay multimillion dollar settlements.

Change in residency training . . . [Full Text PDF of this Article]

Author Affiliations
Cambridge, Mass

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