THIS IS AMERICA - Medical Education

By Jerilyn Watson
THIS IS AMERICA
–
July 15, 2002: Medical Education

VOICE ONE:

Students must study and work for many years to become a doctor in the United States. Working conditions are
often very difficult. I’m Mary Tillotson.

VOICE TWO:

And I’m Steve Ember. Today we tell about doctors in training on the VOA Special
English program, THIS IS AMERICA.

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VOICE ONE:

Men and women in the United States who want to become doctors attend four years of college or university.
They usually study science intensively. They study biology, chemistry and other sciences. If they do not, they
may have to return to college for more education in science before trying to enter medical school. Some students
work for a year or two in a medical or research job before they try to seek a place in a medical college.

There are one-hundred-twenty-five medical colleges in the United States. More than sixty-six-thousand students
are attending medical colleges. It is difficult to gain entrance to them. Those who do the best in their studies have
a greater chance of entering medical school. Each student also must pass a national examination to enter medical
school. Those who get the top scores have the best chance of being accepted. Most people who want to study
medicine seek to enter as many as ten medical schools. This increases their chances of being accepted by one.

Last year, about thirty-five -thousand students applied 1 to medical schools in the United States. About seventeen-
thousand were accepted. A medical education is very costly 2. It costs as much as thirty-thousand dollars for each
year.

VOICE TWO:

After entering medical school, students spend the next four years studying only medical sciences. The first two
years of medical school are spent mainly in class. The students learn about the body and all its systems. They
learn about chemistry and medicines. And they begin studying diseases and how to recognize and treat them.
Many students say the first year of medical school is the most difficult. They must remember a great deal of
information. For example, many schools require that students remember the names of every bone in the body.

VOICE ONE:

By the third year of medical school, students are ready to use their knowledge to begin helping 3 sick people in a
hospital. These students work under the guidance of experienced doctors. Students observe the treatment of
patients. They also examine patients and advise treatment. As the students watch and learn, they think about the
kind of medicine they would like to practice when they become doctors.

Do they want to care for children? Or do they want to care for pregnant 4 women and assist at the birth of babies?
Do they want to treat patients with broken bones? Or do they want to operate on the body or the brain?

During the fourth year of medical school, students begin seeking to enter a medical training program in a
hospital. This training program is called a medical residency. Medical school graduates face strong competition
to gain a resident position at the hospitals they want most. Hospitals want the top medical school graduates.

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VOICE TWO:

Most states require that a person complete at least one year of medical residency before being permitted to take
examinations to practice medicine. Some doctors work for many years as residents in hospitals, depending on
which medical field they have chosen. For example, surgeons spend many years as medical residents to gain the
needed experience performing operations. Some doctors work in hospitals as residents for as many as ten years
before they begin working on their own.

VOICE ONE:

These medical residents provide hospitals with needed services in return for not much pay. They work under the
supervision 5 of medical professors and more experienced doctors. Medical residents treat patients. They carry out
tests. They perform operations. They complete records. In hospitals with few nurses, residents also do work
formerly 6 done by nurses.

During their first year of residency, these doctors in training work in a number of medical services. For example,
they may work in emergency care for one month. Then they may care for children. The next month, they may
work in the operating room. During this time they get a chance to decide what kind of doctor they want to
become.

VOICE TWO:

Some medical residents work one-hundred or more hours in a single week. They often work for more than thirty-
six hours at a time before they can rest. Critics of this system say medical residents work too long and do not get
enough rest. They say these young doctors may be too tired to provide the best care for their patients.

Now, however, an organization that supervises 8 the training of medical residents has decided 9 to change this
policy. The Accreditation 10 Council for Graduate Medical Education says it will limit the number of hours that
residents can work. It acted because of concerns that hospital workers are responsible for many serious mistakes.

VOICE ONE:

The new work limits will begin in about a year. They will affect about one-hundred-thousand medical residents.
Most doctors in training will be limited to eighty hours of work each week. They will have work periods of no
more than twenty-four hours at one time. They will have ten hours of rest between work periods. Medical
residents will have one day each week when they do not have to work. Any work they do outside their hospitals
will be limited. Experienced doctors and medical professors will closely supervise 7 the residents to make sure they
are not too tired to work.

VOICE TWO:

Many medical residents welcome the new policy. They say they often work under tense conditions. Their
decisions may mean the difference between life and death. A young family care doctor in the state of Virginia
says she learned a lot as a medical resident at a southern hospital. But she says she might have learned even more
if she had not been so tired.

Some residents, however, oppose the changes. They say they need extended time with patients to note changes in
their conditions. And some believe they need to work as much as they can to gain the experience they need to
become good doctors.

VOICE ONE:

Reducing working hours for residents means that other people will have to do some of their work. Some hospitals
will have to employ more doctors, nurses and other medical workers. This will mean increased expenses for
hospitals around the country. About thirteen years ago, the state of New York passed a law similar to the new
policy. It limited the work of medical residents to eighty hours of work each week. The state spent more than
two-hundred-million dollars a year to carry out the law.

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VOICE TWO:

Three years ago, the Institute of Medicine of the National Academy of Sciences studied deaths in American
hospitals. Its report estimated that mistakes in hospitals kill at least forty-four thousand Americans each year.

There are no estimates of how many medical residents may have been responsible for these deadly mistakes.
However, its seems likely that a doctor who has not slept in days might make a mistake. Some hospital
investigations 11 reportedly have blamed tired residents for ordering the wrong amount of medicine for their
patients.

VOICE ONE:

Even with their new, reduced hours, medical residents will be working much longer than most Americans. Most
Americans work about eight hours a day. They work about forty hours a week. Some young doctors in hospitals
will be working two times as many hours a week.

However, experts say this is not just a problem of long hours. A medical educator in the state of Illinois has
worked with medical residents. Paul Rockey says medical residencies today are more difficult than they were in
the past. This is because patients do not stay as long in the hospital as they once did. Doctor Rockey says this
change puts a lot of pressure on young doctors to learn quickly from their patients.

Doctor Rockey says the difficulties of modern medical education may be great. But he says young people get
great satisfaction in seeing themselves gain the knowledge and experience to become good doctors.

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VOICE TWO:

This program was written by Jerilyn Watson. It was produced by George Grow. I’m Steve Ember.

VOICE ONE:

And I’m Mary Tillotson. Join us again next week for another report about life in the United States on the VOA
Special English program, THIS IS AMERICA.

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