Journal of the American Medical Association Publishes Studies on Medical Residents, Students
The Sept. 7 issue of the Journal of the American Medical Association includes two studies on medical residents and one study on medical students. Summaries appear below.
About half of residents in a nationwide survey reported they had little or no training in cross-cultural care, according to a study led by researchers at Massachusetts General Hospital and co-sponsored by the Commonwealth Fund, Long Island Newsday reports. According to Newsday, culturally competent care can include understanding how to address patients from different cultural backgrounds, identifying patient mistrust, and understanding religious and cultural customs.
The survey of more than 2,000 residents in their last year of training also found that 20% of residents felt they were not well trained to care for patients whose religious beliefs might affect treatment (Ricks, Long Island Newsday, 9/7). In addition, about one-fourth of residents said they were not prepared to treat patients whose health beliefs differ from those of Western medicine.
Stephen Schoenbaum, executive vice president at the Commonwealth Fund, said, "Although physicians recognize that cultural competency is a necessary component of high-quality care, they are not being given the tools they need to provide this care" (CQ HealthBeat, 9/6).
An abstract of the study is available online.
Residents who worked a "light call" schedule of a 44-hour work week and then consumed liquor until their blood alcohol level reached 0.05% performed better on a driving simulation test than residents who took the test while sober after working a "heavy call" schedule of a 90-hour work week, according to a study led by Todd Arnedt of the University of Michigan, Reuters/New York Post reports (Reuters/New York Post, 9/7). Researchers found that 34 residents at Rhode Island Hospital crashed at about the same rate in a test on a driving simulator when they were sober and coming off heavy call as when they consumed alcohol after a working a light call schedule (Washington Post, 9/7).
Arnedt wrote, "Because sleepy residents may have limited ability to recognize the degree to which they are impaired, residency programs should consider these risks when designing work schedules and develop risk-management strategies for residents, such as considering alternative call schedules or providing post-call napping quarters" (Reuters/New York Post, 9/7).
Co-author Judith Owens, an associate professor of pediatrics at Brown Medical School, said the research is the first study of work-related sleep loss in medical training to compare the effects of sleep loss and alcohol consumption.
National policies adopted in 2003 require working hours in residency programs to average no more than about 80 hours weekly (Washington Post, 9/7).
An abstract of the study is available online.
Third-year medical students receive one gift from a pharmaceutical company or attend industry-sponsored events an average of once weekly, according to a survey of 1,143 third-year students at eight medical schools, the Newark Star-Ledger reports.
About 80% of the students surveyed said they "perceive[d] that the gifts were inappropriate" but felt "entitled" to the gifts, the study said. About half of students surveyed said the gifts included food or books, while 2% said they had received gifts to pay for travel or conference expenses (Jordan, Newark Star-Ledger, 9/7). More than 80% of respondents said they have been asked by a physician to attend at least one lunch sponsored by the pharmaceutical industry, and one-third said gifts from drug companies might influence their practice.
In a second survey, researchers found that only 10% of 126 U.S. medical schools have policies regulating students' interactions with drug companies.
Both surveys were led by John Woodard, an associate professor of psychology at Rosalind Franklin University of Medicine and Science (Washington Post, 9/7).
Representatives for Pfizer, Schering-Plough and Bristol-Myers Squibb declined to comment on the research, the Star-Ledger reports (Newark Star-Ledger, 9/7).
An abstract of the study is available online.