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IR MSR

by katy_123 » Fri Jul 13, 2012 6:26 am
Statement by Medical Residency Association president:
Medical residents play an invaluable role in delivering medical care to the citizens of our community, providing round-the-clock coverage and support to both physician and nursing staff while working to earn our medical licenses. Residents are responsible for all of the licensed physician tasks, including intake, the ordering of tests and labs, diagnosis and treatment, including surgery. Nevertheless, we are taken advantage of terribly by the hospitals: assigned to 24-hour shifts, often undermined or treated poorly by senior doctors - sometimes when patients are present - and paid well below minimum wage. Our pay is fixed and it is assumed that we work only one-third of the hours in our assigned shifts; technically, we are considered merely "on call" during these shifts. We are required to be on the hospital grounds at all times, however, and we work far more than the assumed number of hours per shift. Over the past month, each resident has averaged 17.5 active hours of work during a 24-hour shift; further, while working, each resident has averaged only 3.5 hours of sleep at a time. Such working conditions are dangerous for both patients and residents; some serious mistakes have already been made and were caught only at the last minute by senior staff.



Statement by Hospital Board spokesperson:
We firmly believe that residents are an integral part of the medical care delivery team at our network of hospitals. At the same time, medical residencies are a part of the training process to become a physician; until someone has finished the residency, he or she is not, and cannot reasonably be considered, a licensed physician. Residencies function in much the manner of an apprenticeship of old: hands-on training under the supervision of a fully trained mentor. Residents are not expected to work 24 hours in a 24-hour shift, nor anywhere close to that. They are assigned such shifts merely to ensure that they are on-site when something occurs that would be beneficial to their training. If residents choose to participate in many routine activities that can ably be handled by the nursing or medical staff, that is the residents' choice. Further, the entire system is structured to provide both training and oversight; when a resident is called upon to make a diagnosis or perform a minor procedure, there is always an experienced physician on hand to verify the diagnosis, take over the procedure, or otherwise correct any potential errors.


For each of the following statements, select Both Agree if it can be inferred that the Medical Residency Association president and the Hospital Board spokesperson both agree with the statement. If not, select Otherwise.


Both Agree Otherwise


The degree to which there is a danger of lasting patient harm caused by medical resident errors.


Whether medical residents may work more than 8 hours during a 24-hour shift.


The degree to which a resident is as qualified as a licensed physician.

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by Whitney Garner » Tue Oct 09, 2012 10:59 am
katy_123 wrote:Statement by Medical Residency Association president:
Hi Katy!

Let us know if there is anything specific that you have a question on for this passage, but we can start by going over the reading and the logic behind the choices together.

TAB 1: "Statement by Medical Residency Association president"
Here we have a resident (they refer to the plight of the residents using the pronoun "we" so they include themselves in this grouping) who is obviously upset about the number of hours they work during a shift. The bring several issues to light: (a) they feel undervalued & disrespected, (b) they feel overworked & underpaid, and (c) they are concerned about possible safety ramifications from lack of sleep.

TAB 2: "Statement by Hospital Board spokesperson"
Here we have an administrators response, and they definite disagree in large part with the resident's sentiments. He or she indicates that (a) working excessive hours is not a requirement but a choice, (b) residents are training (not doctors) and cannot be seen as licensed physicians (so likely not paid as they are either), and (c) oversight is always present by people who are NOT residents and so NOT in the same potentially sleep-deprived state.

TOGETHER: Thinking about the Big Picture
It sounds like these 2 folks are at odds with several of the big issues of concern and since that is what this set of statements is asking about (degree of agreement), it would pay to carefully reference the tabs as we work on each one.

Now on to the questions...

Question 1a: "The degree to which there is a danger of lasting patient harm caused by medical resident errors."
The resident obviously thinks that there is a real danger for harm due to the decisions of sleep-deprived residents, but the board spokesperson disagrees because of continuous oversight. This would be an area where I would suggest that the feeling is OTHERWISE.

Question 1b: "Whether medical residents may work more than 8 hours during a 24-hour shift."
In this case the disagreement is not about the number of hours worked but about the reason for why. The resident says it is an expectation while the board member says that it is the resident's choice (so it is the resident's fault if they work so much). In this case, while the 2 parties disagree about the motivations for why, I would say that they BOTH AGREE about the number.

Question 1c: "The degree to which a resident is as qualified as a licensed physician."
Again, the resident says that they are expected to do many of the jobs of a physician while they are working toward their own license, so they aren't saying they ARE licensed, just that they have lots of similar responsibilities (and should be treated with equal respect). The board spokesperson also notes that these residents are not licensed physicians and uses that for justification for why they should be treated differently (ignoring the argument that residents might do many similar jobs). So we see that the two disagree about what it means for these residents to not be licensed, but I would say that they BOTH AGREE that residents are NOT licensed physicians.


Hope this helps!
:)
Whit
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by tanviet » Sun Oct 14, 2012 12:14 am
I see multiple source hardest in IR section. It take me 10 minute to get it wrong.