VOA慢速英语--实习医生应该工作多少小时？

How Many Hours Should Trainee¹ Doctors Work?

The Accreditation² Council for Graduate Medical Education (ACGME) sets rules for most graduate-level training programs for doctors in the United States.

In 2003, the group shortened working hours for U.S. doctors-in-training, known as residents. It limited their work duties to 80 hours a week.

The move caused some members of the medical community to raise questions: Did the reduced hours give residents enough time to learn the art of medicine? And, would future patients suffer?

Now, a study has answers. It found no difference in hospital deaths, hospital readmissions or costs when comparing results from doctors trained before and after the hour limits. The findings appeared in the medical publication BMJ.

The debate about how much time hospital residents should work has a long history. The ACGME notes that as early as the 1970s, studies found that residents were more likely to make mistakes when they failed to get enough sleep.

In 1984, college freshman³ Libby Zion died a short time after being admitted to an emergency room at a New York hospital. A grand jury investigation⁴ found that the long work hours required of residents were partly to blame for her death. In some cases, residents worked as many as 36 hours straight.

“Some (people) still long for the old days of 100-hour work weeks, but most of the world has moved on and realized there are better ways to train residents,” noted⁵ Karl Bilimoria. He is a doctor with the Northwestern University Feinberg School of Medicine. He was not involved in the study.

Bilimoria added that training could become more effective by reducing paperwork and attendance at academic conferences. He also likes the idea of adding more nurse practitioners⁷ to the medical workforce⁸.

Earlier studies suggested the 2003 reforms did not harm residents’ patients. The new study is the first to find similar results for doctors once they work in the real world, notes Doctor Mitesh Patel of the University of Pennsylvania. He was not involved with the study.

Isaiah Cochran worked 75 hours a week, including some 16-hour shifts, at Dayton Children’s Hospital in Ohio during his last year of medical school.

“It’s doable. It’s not insane,” said Cochran, who serves as president of the American Medical Student Association. His group supports keeping the 80-hour limit and other measures aimed at making sure residents get enough rest.

For the study, researchers looked at records from more than 400,000 hospitalizations of U.S. patients. Each of the patients was covered under Medicare, the national health insurance program.

Using billing information, the researchers identified a doctor who dealt with each patient the most. Then they compared cases from two six-year time periods: before and after 2006. That is the year when the first new doctors who were fully⁹ affected¹⁰ by the reforms finished their residencies.

The researchers found no difference in patient deaths, hospital readmissions or costs.

Patients depend on teams of health care workers, not just one doctor, and that may explain why doctor training time seemed to have no effect on care.

Teamwork and technology have changed hospital care so much that the effect of any one doctor is not great, said Anupam Jena of Harvard Medical School. Doctor Jena was the lead author of the published report on the study.

And more change is expected with artificial intelligence. With computers taking a larger role in diagnosis¹¹ and treatment, Jena said, “it should be an open question whether 80 hours a week is the right number” for training. Maybe it could be less.

The results apply to doctors specializing in internal medicine, not surgeons. More research is needed on whether surgeons are getting enough experience during training, Jena said.

I'm Jill Robbins.

And I’m John Russell.

Words in This Story

graduate – adj. of or relating to a course of studies taken at a college or university after earning a bachelor's degree or other first degree

academic – adj. of or relating to schools and education

nurse practitioner⁶ – n. a trained nurse or medical aide who can treat some medical conditions without a doctor’s direct supervision¹²

shift – n. the scheduled period of time during which a person works

insane – adj. very foolish or unreasonable¹³

artificial intelligence – n. the power of a machine to copy intelligent human behavior

internal medicine – adj. the work of a doctor who treats diseases that do not require surgery

surgeon – n. a doctor who performs operations that involve cutting into someone's body in order to repair or remove damaged or diseased parts : a doctor who performs surgery

1 trainee   

n.受训练者

参考例句：

• The trainee checked out all right on his first flight.受训者第一次飞行完全合格。
• Few of the trainee footballers make it to the top.足球受训人员中没有几个能达到顶级水平。

2 accreditation   

n.委派，信赖，鉴定合格

参考例句：

• a letter of accreditation 一份合格证明书
• This paper gives an overview of the Verification, Validation and Accreditation (VV&A) in High Level Architecture(HLA). 对基于高层体系结构(High Level Architecture,简称HLA)的仿真系统的校核、验证与确认(Verification, Validation and Accreditation,简称VV&A)问题进行了详细的介绍及分析。 来自互联网

3 freshman   

n.大学一年级学生(可兼指男女)

参考例句：

• Jack decided to live in during his freshman year at college.杰克决定大一时住校。
• He is a freshman in the show business.他在演艺界是一名新手。

4 investigation   

n.调查，调查研究

参考例句：

• In an investigation,a new fact became known, which told against him.在调查中新发现了一件对他不利的事实。
• He drew the conclusion by building on his own investigation.他根据自己的调查研究作出结论。

5 noted   

adj.著名的，知名的

参考例句：

• The local hotel is noted for its good table.当地的那家酒店以餐食精美而著称。
• Jim is noted for arriving late for work.吉姆上班迟到出了名。

6 practitioner   

n.实践者，从事者；(医生或律师等)开业者

参考例句：

• He is an unqualified practitioner of law.他是个无资格的律师。
• She was a medical practitioner before she entered politics.从政前她是个开业医生。

7 practitioners   

n.习艺者，实习者( practitioner的名词复数 )；从业者（尤指医师）

参考例句：

• one of the greatest practitioners of science fiction 最了不起的科幻小说家之一
• The technique is experimental, but the list of its practitioners is growing. 这种技术是试验性的，但是采用它的人正在增加。 来自辞典例句

8 workforce   

n.劳动大军，劳动力

参考例句：

• A large part of the workforce is employed in agriculture.劳动人口中一大部分受雇于农业。
• A quarter of the local workforce is unemployed.本地劳动力中有四分之一失业。

9 fully   

adv.完全地，全部地，彻底地；充分地

参考例句：

• The doctor asked me to breathe in,then to breathe out fully.医生让我先吸气，然后全部呼出。
• They soon became fully integrated into the local community.他们很快就完全融入了当地人的圈子。

10 affected   

adj.不自然的，假装的

参考例句：

• She showed an affected interest in our subject.她假装对我们的课题感到兴趣。
• His manners are affected.他的态度不自然。

11 diagnosis   

n.诊断，诊断结果，调查分析，判断

参考例句：

• His symptoms gave no obvious pointer to a possible diagnosis.他的症状无法作出明确的诊断。
• The engineer made a complete diagnosis of the bridge's collapse.工程师对桥的倒塌做一次彻底的调查分析。

12 supervision   

n.监督，管理

参考例句：

• The work was done under my supervision.这项工作是在我的监督之下完成的。
• The old man's will was executed under the personal supervision of the lawyer.老人的遗嘱是在律师的亲自监督下执行的。

13 unreasonable   

adj.不讲道理的，不合情理的，过度的

参考例句：

• I know that they made the most unreasonable demands on you.我知道他们对你提出了最不合理的要求。
• They spend an unreasonable amount of money on clothes.他们花在衣服上的钱太多了。