Help Train Future Physicians: Say Yes to Interns & Residents

I've been "in" medicine for close to a quarter century now (pretty scary) on both sides of the table & auditorium, first as a student, then as an intern (1st year resident), resident (in family medicine) & fellow (in geriatrics), and finally as an attending physician, training our future providers of care.  In retrospect, I am very grateful to all the patients who allowed me to participate in their care and gain the experience necessary to care for and pass onto others.  Without their permission, I would not be where I am today.  

Thus, I've always struggled with how to respond when informed of patients who request that no physicians-in-training, whether med students, interns, residents, and/or fellows, be involved in their care.  Luckily, there aren't too many of these patients (at least not at the School of Medicine where my family and I receive our care).  I guess they self-select in that those who don't want trainees go to private hospitals, whereas those who don't care, don't know, or don't have a choice go to teaching hospitals, where it's expected that trainees (of all kinds) will be involved.

Therefore, I'm happy to report that a study published just last month concluded that resident participation was associated with lower mortality.  Specifically, the American College of Surgeons reviewed 607,683 surgical cases and found greater morbidity with resident participation in vascular procedures, pancreatectomy, esophagectomy, and colorectal resections.  On the other hand, and more important at that, there was a slight decrease in mortality.  In the final analysis, resident involvement was associated with 6.1 additional morbid events but 1.4 fewer deaths per 1,000 procedures.

Granted, I'm not a surgeon, but it's good to know that surgical training doesn't negatively impact patient care & outcome.  And let's not forget that surgeons (and physicians) continue to learn new procedures & techniques even after finishing their formal training.  Without patients willing to have a physician learn & practice his/her newly acquired skill, progress could not be made (or at least not at its current rate).  So thank you to all of you who have helped train physicians.