Graduate Medical Education

Swiss study offers lessons in duty-hour restrictions

As resident duty-hour restrictions continue to be a contentious issue in graduate medical education, one country with much stricter rules offers examples for consideration before future policies are crafted.

A new study from Switzerland, where a 50-hour work week is the law, revealed that, despite increased rest time, the restrictions have not improved surgical patient safety. The authors conclude that the "focus of regulatory agencies and labor unions should change from hours worked to other aspects within work-hour limits." 

The authors also reviewed literature from the United States on resident duty hours and found that the reduction to 80 hours has shown neither a clear positive effect on patients' outcomes and safety nor a clear negative effect of working in shifts, with self-evidently more handovers, transfers and subsequent impact on continuity of patient care.

The AMA offers resources to help residents navigate their work environment and improve patient handoffs, one of the adverse effects associated with duty-hour restrictions.

Go team! Success in residency tied to team sports

A recent study in the Archives of Otolaryngology-Head & Neck Surgery found that among medical students, prior achievement in team sports correlated with successful completion of residency more than standardized test scores, application interviews or faculty recommendations.

The authors speculate that this link is related to the team nature of medicine, particularly in surgery. The study found no significant link between residency success and having a particular athletic skill—only excelling in team sports.

Residency director blogs through year of training

Residents can compare notes on their program experiences through a new blog by John Henning Schumann, MD, director of the University of Oklahoma Internal Medicine Residency Program.

Hosted online by The Atlantic, the blog provides Dr. Schumann with a platform to walk the readers through a year in the life of an intern resident physician at his institution. In his first entry, Dr. Schumann discusses the "July phenomenon" and hospital safety during periods of resident transition.

The AMA helps residents prepare for their years in training through its comprehensive resource "Succeeding from Medical School to Practice."

Coming soon: A global standard for medical education

A 2023 requirement that all international medical graduates (IMGs) graduate from appropriately accredited medical schools to practice in the United States is fueling global education requirements, according to a story in American Medical News.

The rule states that any IMG seeking certification by the Educational Commission for Foreign Medical Graduates (ECFMG) must graduate from a medical school accredited under internationally accepted standards set forth by the World Federation for Medical Education. With more than 2,500 medical schools worldwide, the initiative is a huge effort, ECFMG President and CEO Emmanuel G. Cassimatis, MD, told American Medical News.

One expert said that the standards will help weed out schools that provide an inferior education. "We do need a single set of standards," he said. "It's a challenge facing the world."

AMA resident/fellow survey to be released this month

The National GME Census, co-owned by the AMA and the Association of American Medical Colleges, has two components: the program survey and the resident/fellow survey. The program survey has been open on GME Track since mid-May, with a response rate of more than 85 percent.

The resident/fellow survey was scheduled to open July 18 but has been delayed. The survey is expected to open in the third week of September. Program directors and coordinators will receive an email as soon as the survey is open. Meanwhile, programs are encouraged to collect the information needed to complete the survey. All deadlines for completion will be moved back to accommodate the delay.

Email GME Track with any questions.

News and notes

• What do residents think about the final year of medical school? (International Journal of Medical Education)
• The new resident physician duty hour limits are "impeding [residents'] ability to offer the best care" and "compromising the education and training of young doctors," according to commentary by an internal medicine resident in the National Review.
• Register for "Clinical Learning Environment Review Program: Purpose, Process, and Strategies for Success," an audio conference hosted by the Association for Hospital Medical Education at 1 p.m. Eastern on Oct. 9, featuring Kevin Weiss, MD, senior vice-president for Institutional Accreditation at the Accreditation Council for Graduate Medical Education.
• Training Administrators in Graduate Medical Education now offers certification in 27 specialties, with cardiovascular disease, pediatric emergency medicine, gastroenterology, and hematology and oncology currently under development.

AMA resources for you and your trainees

• View an archive version of our webinar on ways to expand and improve GME
• Check out our new recommendations on strategies to expand funding of GME
• Get trend data on undergraduate and graduate medical education
• Watch a YouTube video summary of the New Horizons in Medical Education conference
• Help your residents master the ACGME general competency requirements
• Learn more about patient safety in medical education
• Get updated information on medical licensure
• Obtain state-by-state GME data
• Get an updated copy of our GME glossary (email meded@ama-assn.org with "glossary" in subject line)

For more reading

• AMA medical education and professional ethics Twitter pages
• American Medical News
• Ending Disparities e-Letter