Residencies get flexible: Doctors taking personal time

Educators respond as residents ask for time to put outside interests into their schedules.

By Myrle Croasdale, AMNews staff. July 24/31, 2006.

The newest generation of medical students and residents is reshaping residencies. With their dual commitments to medicine and a life outside of the hospital, Generations X and Y, after eight years of college and medical school, are unwilling to defer personal goals any longer. Residents are asking for time away not only to have children, but to work internationally, do research and travel.

As a result, anecdotal evidence points to a growing number of programs factoring in leaves of absences for residents in those generations that include today's teenagers to those in their early 40s, experts said.

A fraction of the efforts are structured as part-time residencies, which can double the time required to graduate. But the bulk appear to be of shorter duration, created for individuals as needed.

In 2004-05, 302 residents were part time, according to the Accreditation Council for Graduate Medical Education.

In a study, Stephanie Pincus, MD, professor emeritus at State University of New York at Buffalo and former chief academic affiliations officer for the Dept. of Veterans Affairs, pegged the number of programs offering structured part-time options at 3.8% of the 8,000 ACGME-accredited residency programs.

From either perspective, the number of part-time residents is tiny. However, educators say anecdotal reports of full-time residents taking a leave of absence are growing.

"My sense of things is that the younger physicians, the ones currently in medical school, are going to be the ones to say, 'Hey, wait a minute, I'm not going to do this,' and will be less tolerant of what a nonphysician considers an excessive workload," Dr. Pincus said. "I don't believe the young people coming in are going to accept that, regardless of whether or not they have families."