Dr. Barry Gustin - Medical-Legal Expert Services

Changes in Doctor Training

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A national panel of medical experts proposed significant and costly changes for training new doctors in the nation's hospitals, recommending mandatory sleep breaks and more structured shift changes to reduce the risk of fatigue-related errors.

The report, issued by the Institute of Medicine, focused on the grueling training of medical residents, the recent medical school graduates who care for patients under the supervision of a fully-licensed physician. The medical residency, which aims to educate doctors by fully immersing them in a particular specialty and all aspects of patient care, is characterized by heavy patient workloads, 80-hour workweeks and sleep deprivation.

Dr. Gustin's comments: Fatigue causes errors; errors of omission and errors of commission, because judgment is affected. This leads directly to patient injury and potential medical malpractice actions.

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