When Their Residence Isnt the Hospital – What Do You Call Physician Trainees

Residents training to be neurosurgeons started out working in essence around the clock for almost no money.

Odd label, “residents,” for medical doctors who are preparing to be fully-trained surgical specialists charged with caring for patients who may be very ill, and who sometimes can do surgical procedures that their presumed teachers and supervisors cannot. The origin of this term sheds light on the long hours that residents have “traditionally” worked such that an 88-hour workweek is viewed as a veritable sinecure.

Through the late 19th century, medical and surgical education followed a haphazard apprenticeship model. No formal education was required. Didactic learning was obtained through courses given by voluntary faculty lecturing in medical schools. Students bought tickets to attend, and when the time was right they attached themselves to a practitioner from whom they learned the art of medicine and/or surgery. When Harvey incredibly hard, by most standards, for a living wage. Now organized neurosurgery has accepted the concept of strictly defined limitations on work hours. Residents still work long and hard but no longer have to fear that a sleepless night will be followed by a day without end. Some people may consider this a needless accommodation. Others might call it progress.

Michael Schulder, MD, is associate professor in the Department of Neurological Surgery and director of image-guided neurosurgery at UMDNJ-New Jersey Medical School in Newark.

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