5 ms·

Consider the plight of the medical student though. Worse than that of a CS grad student, that's for sure. Made to practice medicine on people while sleep depr

Consider the plight of the medical student though. Worse than that of a CS grad student, that's for sure. Made to practice medicine on people while sleep deprived as a form of industry-approved hazing, a practice that doubtlessly has a substantial death toll associated with it.

munherty 7y ago
Never understood why this doesnt get any press. Its absurd
- blueboo 7y ago
  Gets lots of press. Google doctor interns lack of sleep for a litany of deeply-researched news articles. Hospitals are being privatised and private universities dominate medical education. Where’s the political pressure point?
- throwaway1777 7y ago
  It gets press but only so many ways to report the same story for years on end.
- sandworm101 7y ago
  It gets press, but it also a legitimate training technique in many fields. There is something to be said for living and breathing nothing but your job for a period of time. Stress and the ability to perform despite stress is also something that must be learned through experience. Doctors, attorneys, the entire military ... the juniors are run through a few years of long hours and horrible conditions. The downsides have to be weighed against the training value.
  - watwut 7y ago
    The military is trying to mold you the same to make you replaceable and obeisant. Doctors don't need to be all the same.
    - sandworm101 7y ago
      Replaceable and obeisant? You've watched too many movies. Skills learned while under stress will be with you when you are under stress again later. A doctor is trained under stress so that in the future, when their patients are about to die in front of them, that they react as trained. A doctor will see more blood, more death, than most soldiers. The parallels in stressed training are not insignificant, and have nothing to do with obedience.
      - leoh 7y ago
        That's just not true. Being trained in a relentlessly stressful environment means that you're less likely to be creative, thoughtful, and empathetic in the solutions you come up with. It can also lead to learned helplessness -- a sense that things must be done the way they've always been done, because there's just not enough time and space from others to do things properly.
      - imesh 7y ago
        During residency they are dealing with patients dying in front of them. The stress is already there. I don't see why being sleep deprived is a benefit.
      - watwut 7y ago
        Basic training is literally about making them think and act certain way. It is literally about them all teaching exactly same set of super basic skills so that the soldiers are replaceable by the end by each other. There is reason why soldiers personality changes after basic training (that is what their families and partners say). More complex skills are not taught in basic training, but later in specializations. Under stress and duress and lack of sleep, people learn less. Moreover, while soldiers do in fact have to work in difficult physical conditions in action, doctors don't. And I am not even sure what death on itself has to do with it. Conditions of encountering it are incredibly different in both professions.
        citboin 7y ago
        “...Moreover, while soldiers do in fact have to work in difficult physical conditions in action, doctors don't. And I am not even sure what death on itself has to do with it. Conditions of encountering it are incredibly different in both professions.” Try working in an inner city ER at night when it can often feel very similar to a war zone. Instead of sandbags and soldiers with rifles we’re surrounded by bulletproof glass and police officers.
  - andrewflnr 7y ago
    You still need sleep to form long term memories and make good decisions. Sleep deprivation is inhumane to the students and deadly to patients. There is no excuse.
    - sandworm101 7y ago
      You do realize that this isn't the entire training scheme? This is one stage of a multi-year process, starting long before med school. The most effective thing for patients would be to never be treated by trainee doctors but that isn't a practical option.
      - andrewflnr 7y ago
        Yes. What's your point? Hopefully it's not that since patients are going to be treated by students, we may as well give up and have them treated by sleep-deprived students, or that sanity in one phase of the training process excuses insanity in another. But if you're not trying to make one of those arguments, I don't know how your comment is relevant.
chronic839 7y ago
> Consider the plight of the medical student though. While not as bad, ML/NLP/CV/AI grad school is still pretty bad. Maybe 60-70% of what med students (more specifically, residents) go through.
- Kephael 7y ago
  Graduate school is probably worse because it's not time boxed and what you're trying to do may not actually be possible. When you leave your medical residency for the day you don't have the option to continue working.
  - 0xB31B1B 7y ago
    Wife is in surgery residency, they do a lot of research projects, there is a lot of work to take home
    - stephencanon 7y ago
      It never ends. Wife is an attending surgeon, and she's currently working on refining a grant proposal at 9pm on Sunday =).
      - deleted 7y ago
        [deleted]
- eli_gottlieb 7y ago
  >While not as bad, ML/NLP/CV/AI grad school is still pretty bad. Uhhhhh what? I'm in grad school right now. I feel... a lot better-off than any medical student or resident I've ever met, or even than my wife, who's a high-school science teacher (God help her!).
- benmaraschino 7y ago
  No way. It's not even close. And I say this as a PhD candidate in one of these fields at Stanford. Grad school is what you make of it, to a large extent. There's definitely toxicity, but it's not as systematic or ritualized to the extent that it is in medicine. In grad school, you have wide leeway over who you work with, and you can distance yourself from the toxic personalities if that's what you want to do without taking a career hit. That's not really possible in medicine.
avocado4 7y ago
Excessive working hours are used as an excuse by medical cartel to justify practices that drive down the supply of providers through licensing requirements, and drive up salaries for doctors and everybody else up the chain. "See how hard we are working and how long we had to stay in school? We deserve to charge $500 for a 10 minute visit". "An acne cream that Europeans get over the counter for $5? We studied for 10 years and we know best what's safest for patients, so they HAVE to go to us first to get a $300 prescription." This is literally the arguments that medical associations have been using to lobby state and federal agencies to keep the status quo. What needs to be done is a dramatic shift of power away from doctors in the medical industry. Flooding of medical labor markets with mid-levels - nurses, PAs, RAs, PTs - and relaxing respective scope of practice laws. Physicians will fight to death against new competition, even if it means killing themselves with unreasonable working hours. https://www.auntminnie.com/Forum/tm.aspx?m=581583 https://www.auntminnie.com/Forum/tm.aspx?m=581583 "Don’t teach your mid levels procedures... Ultimately, a mid level that can do procedures, even easy ones, are your competitors." https://www.politico.com/agenda/story/2017/10/25/doctors-salaries-pay-disparities-000557 https://www.politico.com/agenda/story/2017/10/25/doctors-sal...
- oarabbus_ 7y ago
  Excellent comment. The AAMC and AACOM quite literally fit the definitions of cartels, artificially restricting the supply of medical doctors. Also, it's the 21st century - why do doctors (more specifically, hospitals) generally work 9-5 M-F? Viruses and bacteria don't take the weekends off. Not to mention when people need to see a specialist, they need to wait weeks or even months for an appointment. Why? It's absurd. With a larger supply of doctors and something like 7am-10pm daily hours, it would result in a massive net benefit to society.
  - jac241 7y ago
    "The AAMC strongly supports bipartisan GME legislation introduced in both the House of Representatives and the Senate, the Resident Physician Shortage Reduction Act of 2019 (H.R. 1763, S. 348)" - https://news.aamc.org/for-the-media/article/gme-funding-doctor-shortage/ https://news.aamc.org/for-the-media/article/gme-funding-doct...
crimsonalucard 7y ago
It's done to keep supply down. Medical costs are high partially because of lack of doctors willing to put up with this. Talk to the AMA.

munherty 7y ago

Never understood why this doesnt get any press. Its absurd

blueboo 7y ago
Gets lots of press. Google doctor interns lack of sleep for a litany of deeply-researched news articles. Hospitals are being privatised and private universities dominate medical education. Where’s the political pressure point?
throwaway1777 7y ago
It gets press but only so many ways to report the same story for years on end.
sandworm101 7y ago
It gets press, but it also a legitimate training technique in many fields. There is something to be said for living and breathing nothing but your job for a period of time. Stress and the ability to perform despite stress is also something that must be learned through experience. Doctors, attorneys, the entire military ... the juniors are run through a few years of long hours and horrible conditions. The downsides have to be weighed against the training value.
- watwut 7y ago
  The military is trying to mold you the same to make you replaceable and obeisant. Doctors don't need to be all the same.
  - sandworm101 7y ago
    Replaceable and obeisant? You've watched too many movies. Skills learned while under stress will be with you when you are under stress again later. A doctor is trained under stress so that in the future, when their patients are about to die in front of them, that they react as trained. A doctor will see more blood, more death, than most soldiers. The parallels in stressed training are not insignificant, and have nothing to do with obedience.
    - leoh 7y ago
      That's just not true. Being trained in a relentlessly stressful environment means that you're less likely to be creative, thoughtful, and empathetic in the solutions you come up with. It can also lead to learned helplessness -- a sense that things must be done the way they've always been done, because there's just not enough time and space from others to do things properly.
    - imesh 7y ago
      During residency they are dealing with patients dying in front of them. The stress is already there. I don't see why being sleep deprived is a benefit.
    - watwut 7y ago
      Basic training is literally about making them think and act certain way. It is literally about them all teaching exactly same set of super basic skills so that the soldiers are replaceable by the end by each other. There is reason why soldiers personality changes after basic training (that is what their families and partners say). More complex skills are not taught in basic training, but later in specializations. Under stress and duress and lack of sleep, people learn less. Moreover, while soldiers do in fact have to work in difficult physical conditions in action, doctors don't. And I am not even sure what death on itself has to do with it. Conditions of encountering it are incredibly different in both professions.
      - citboin 7y ago
        “...Moreover, while soldiers do in fact have to work in difficult physical conditions in action, doctors don't. And I am not even sure what death on itself has to do with it. Conditions of encountering it are incredibly different in both professions.” Try working in an inner city ER at night when it can often feel very similar to a war zone. Instead of sandbags and soldiers with rifles we’re surrounded by bulletproof glass and police officers.
- andrewflnr 7y ago
  You still need sleep to form long term memories and make good decisions. Sleep deprivation is inhumane to the students and deadly to patients. There is no excuse.
  - sandworm101 7y ago
    You do realize that this isn't the entire training scheme? This is one stage of a multi-year process, starting long before med school. The most effective thing for patients would be to never be treated by trainee doctors but that isn't a practical option.
    - andrewflnr 7y ago
      Yes. What's your point? Hopefully it's not that since patients are going to be treated by students, we may as well give up and have them treated by sleep-deprived students, or that sanity in one phase of the training process excuses insanity in another. But if you're not trying to make one of those arguments, I don't know how your comment is relevant.

chronic839 7y ago

> Consider the plight of the medical student though. While not as bad, ML/NLP/CV/AI grad school is still pretty bad. Maybe 60-70% of what med students (more specifically, residents) go through.

Kephael 7y ago
Graduate school is probably worse because it's not time boxed and what you're trying to do may not actually be possible. When you leave your medical residency for the day you don't have the option to continue working.
- 0xB31B1B 7y ago
  Wife is in surgery residency, they do a lot of research projects, there is a lot of work to take home
  - stephencanon 7y ago
    It never ends. Wife is an attending surgeon, and she's currently working on refining a grant proposal at 9pm on Sunday =).
    - deleted 7y ago
      [deleted]
eli_gottlieb 7y ago
>While not as bad, ML/NLP/CV/AI grad school is still pretty bad. Uhhhhh what? I'm in grad school right now. I feel... a lot better-off than any medical student or resident I've ever met, or even than my wife, who's a high-school science teacher (God help her!).
benmaraschino 7y ago
No way. It's not even close. And I say this as a PhD candidate in one of these fields at Stanford. Grad school is what you make of it, to a large extent. There's definitely toxicity, but it's not as systematic or ritualized to the extent that it is in medicine. In grad school, you have wide leeway over who you work with, and you can distance yourself from the toxic personalities if that's what you want to do without taking a career hit. That's not really possible in medicine.

avocado4 7y ago

Excessive working hours are used as an excuse by medical cartel to justify practices that drive down the supply of providers through licensing requirements, and drive up salaries for doctors and everybody else up the chain. "See how hard we are working and how long we had to stay in school? We deserve to charge $500 for a 10 minute visit". "An acne cream that Europeans get over the counter for $5? We studied for 10 years and we know best what's safest for patients, so they HAVE to go to us first to get a $300 prescription." This is literally the arguments that medical associations have been using to lobby state and federal agencies to keep the status quo. What needs to be done is a dramatic shift of power away from doctors in the medical industry. Flooding of medical labor markets with mid-levels - nurses, PAs, RAs, PTs - and relaxing respective scope of practice laws. Physicians will fight to death against new competition, even if it means killing themselves with unreasonable working hours. https://www.auntminnie.com/Forum/tm.aspx?m=581583 https://www.auntminnie.com/Forum/tm.aspx?m=581583 "Don’t teach your mid levels procedures... Ultimately, a mid level that can do procedures, even easy ones, are your competitors." https://www.politico.com/agenda/story/2017/10/25/doctors-salaries-pay-disparities-000557 https://www.politico.com/agenda/story/2017/10/25/doctors-sal...

oarabbus_ 7y ago
Excellent comment. The AAMC and AACOM quite literally fit the definitions of cartels, artificially restricting the supply of medical doctors. Also, it's the 21st century - why do doctors (more specifically, hospitals) generally work 9-5 M-F? Viruses and bacteria don't take the weekends off. Not to mention when people need to see a specialist, they need to wait weeks or even months for an appointment. Why? It's absurd. With a larger supply of doctors and something like 7am-10pm daily hours, it would result in a massive net benefit to society.
- jac241 7y ago
  "The AAMC strongly supports bipartisan GME legislation introduced in both the House of Representatives and the Senate, the Resident Physician Shortage Reduction Act of 2019 (H.R. 1763, S. 348)" - https://news.aamc.org/for-the-media/article/gme-funding-doctor-shortage/ https://news.aamc.org/for-the-media/article/gme-funding-doct...

crimsonalucard 7y ago

It's done to keep supply down. Medical costs are high partially because of lack of doctors willing to put up with this. Talk to the AMA.