Came across this comment from a doctor while researching for my bioethics final paper.
As a senior medical student about to move on to residency, the overwhelming emotion I have at this time is one of disillusionment. At the heart of the Hippocratic Oath, both classical and modern, is the vow to avoid doing harm and to help when appropriate and necessary. Yet medical education, both undergraduate and graduate, brutalizes its students.
Sleep deprivation is the norm—I have seen residents working up to 120 hours a week. With such inhuman work hours for so many years, alienation from one’s family, health, and peace of mind is often the result. Falling asleep at the wheel is common, and deaths of both residents and medical students have been noted in the press. Medical mistakes are inevitable when people are so exhausted. The medical literature clearly and unequivocally states the risk to health and even life when people are sleep deprived, but medical educators seem to believe that somehow, magically, doctors can rise above their own physiology. Physical and psychological abuse from attending physicians are common complaints of both residents and students.
To quote from the Annals of Internal Medicine, “For many residents, fatigue cultivates anger, resentment, and bitterness rather than kindness, compassion, or empathy” (Annals of Internal Medicine 123(1995):512-517). How are we to provide compassionate care to others when our own educational system is the model of abuse? Primum non nocere indeed—the hypocrisy of this oath is that we can’t even manage to muster nonmaleficence to practitioners of our own profession, let alone our patients.