For Residents

Some residents bring the flu to work, survey says

A number of doctors-in-training have gone to work with flu symptoms, potentially passing their bugs on to vulnerable patients, according to a new survey published in the Archives of Internal Medicine.

The survey, conducted by Anupam Jena, MD, a senior resident at Massachusetts General Hospital in Boston, asked 150 residents whether they worked with flulike symptoms in the prior training year and, if they did, their reasons for doing so. He found that 51 percent reported working with flulike symptoms at least once in the last year, and 16 percent reported working sick at least three times.

Among residents who chose to work when sick, the most frequently reported reasons were an obligation to colleagues and an obligation to patient care. Those figures totaled 57 percent and 56 percent of all residents, respectively).

Dr. Jena writes that the sacrifice, despite good intentions, is generally not worth the unintended consequences. In addition to potentially infecting patients, sick residents are "less productive and more likely to make errors." Most hospitals have rules to prevent health workers from coming to work with infectious diseases, although Dr. Jena questions the degree to which they're enforced.

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Post-interview contact adds stress for matching trainees

Varying interpretations of the guidelines on post-interview match communication may be creating additional stress for doctors-in-training, writes Diana S. Curran, MD, in a study published in the Journal of Graduate Medical Education.

In her survey of obstetrician and gynecology program directors, 76.6 percent reported that their programs initiated contact with residency candidates after interviewing them. Of those, 28.7 percent said they did so all of the time, 21.3 percent said they did so most of the time and 26.6 percent said they sometimes did so. Only 23.4 percent reported never initiating post-interview contact with candidates.

While post-interview contact is not itself prohibited, the substances of some of these communications are cause for some concern. More than half of the respondents, 51.5 percent, also reported that highly desirable candidates might be contacted to inform them they were ranked to match.

This variance in policies among programs creates a "game playing" for candidates as they attempt to guess at and interpret the meaning of program communications, Dr. Curran wrote. She calls for more uniformity among programs and said she hopes her study will spur discussion between obstetrician and gynecology program directors, the National Resident Matching Program (NRMP), the Accreditation Council for Graduate Medical Education and medical schools to "protect candidates from inappropriate pressure."

Learn about the NRMP matching process by viewing the AMA resource "Succeeding from Medical School to Practice." AMA members have exclusive access to this two-part guide that offers members the tools needed to succeed at every stage of their career.