VOICE ONE:
Students must study and work for many years to become a doctor inthe United States. Working conditions are often very difficult. I’mMary Tillotson.
VOICE TWO:
And I’m Steve Ember. Today we tell about doctors in training onthe VOA Special English program, THIS IS AMERICA.
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VOICE ONE:
Men and women in the United States who want to become doctorsattend four years of college or university. They usually studyscience intensively. They study biology, chemistry and othersciences. If they do not, they may have to return to college formore education in science before trying to enter medical school.Some students work for a year or two in a medical or research jobbefore they try to seek a place in a medical college.
There are one-hundred-twenty-five medical colleges in the UnitedStates. More than sixty-six-thousand students are attending medicalcolleges. It is difficult to gain entrance to them. Those who do thebest in their studies have a greater chance of entering medicalschool. Each student also must pass a national examination to entermedical school. Those who get the top scores have the best chance ofbeing accepted. Most people who want to study medicine seek to enteras many as ten medical schools. This increases their chances ofbeing accepted by one.
Last year, about thirty-five-thousand students applied to medicalschools in the United States. About seventeen-thousand wereaccepted. A medical education is very costly. It costs as much asthirty-thousand dollars for each year.
VOICE TWO:
After entering medical school, students spend the next four yearsstudying only medical sciences. The first two years of medicalschool are spent mainly in class. The students learn about the bodyand all its systems. They learn about chemistry and medicines. Andthey begin studying diseases and how to recognize and treat them.Many students say the first year of medical school is the mostdifficult. They must remember a great deal of information. Forexample, many schools require that students remember the names ofevery bone in the body.
VOICE ONE:
By the third year of medical school, students are ready to usetheir knowledge to begin helping sick people in a hospital. Thesestudents work under the guidance of experienced doctors. Studentsobserve the treatment of patients. They also examine patients andadvise treatment. As the students watch and learn, they think aboutthe kind of medicine they would like to practice when they becomedoctors.
Do they want to care for children? Or do they want to care forpregnant women and assist at the birth of babies? Do they want totreat patients with broken bones? Or do they want to operate on thebody or the brain?
During the fourth year of medical school, students begin seekingto enter a medical training program in a hospital. This trainingprogram is called a medical residency. Medical school graduates facestrong competition to gain a resident position at the hospitals theywant 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 ofmedical residency before being permitted to take examinations topractice medicine. Some doctors work for many years as residents inhospitals, depending on which medical field they have chosen. Forexample, surgeons spend many years as medical residents to gain theneeded experience performing operations. Some doctors work inhospitals as residents for as many as ten years before they beginworking on their own.
VOICE ONE:
These medical residents provide hospitals with needed services inreturn for not much pay. They work under the supervision of medicalprofessors and more experienced doctors. Medical residents treatpatients. They carry out tests. They perform operations. Theycomplete records. In hospitals with few nurses, residents also dowork formerly done by nurses.
During their first year of residency, these doctors in trainingwork in a number of medical services. For example, they may work inemergency care for one month. Then they may care for children. Thenext month, they may work in the operating room. During this timethey 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 singleweek. They often work for more than thirty-six hours at a timebefore they can rest. Critics of this system say medical residentswork too long and do not get enough rest. They say these youngdoctors may be too tired to provide the best care for theirpatients.
Now, however, an organization that supervises the training ofmedical residents has decided to change this policy. TheAccreditation Council for Graduate Medical Education says it willlimit the number of hours that residents can work. It acted becauseof concerns that hospital workers are responsible for many seriousmistakes.
VOICE ONE:
The new work limits will begin in about a year. They will affectabout one-hundred-thousand medical residents. Most doctors intraining will be limited to eighty hours of work each week. Theywill have work periods of no more than twenty-four hours at onetime. They will have ten hours of rest between work periods. Medicalresidents 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 supervisethe residents to make sure they are not too tired to work.
VOICE TWO:
Many medical residents welcome the new policy. They say theyoften work under tense conditions. Their decisions may mean thedifference between life and death. A young family care doctor in thestate of Virginia says she learned a lot as a medical resident at asouthern hospital. But she says she might have learned even more ifshe had not been so tired.
Some residents, however, oppose the changes. They say they needextended time with patients to note changes in their conditions. Andsome believe they need to work as much as they can to gain theexperience they need to become good doctors.
VOICE ONE:
Reducing working hours for residents means that other people willhave to do some of their work. Some hospitals will have to employmore doctors, nurses and other medical workers. This will meanincreased expenses for hospitals around the country. About thirteenyears ago, the state of New York passed a law similar to the newpolicy. It limited the work of medical residents to eighty hours ofwork each week. The state spent more than two-hundred-milliondollars a year to carry out the law.
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VOICE TWO:
Three years ago, the Institute of Medicine of the NationalAcademy of Sciences studied deaths in American hospitals. Its reportestimated that mistakes in hospitals kill at least forty-fourthousand Americans each year.
There are no estimates of how many medical residents may havebeen responsible for these deadly mistakes. However, its seemslikely that a doctor who has not slept in days might make a mistake.Some hospital investigations reportedly have blamed tired residentsfor ordering the wrong amount of medicine for their patients.
VOICE ONE:
Even with their new, reduced hours, medical residents will beworking much longer than most Americans. Most Americans work abouteight hours a day. They work about forty hours a week. Some youngdoctors in hospitals will be working two times as many hours a week.
However, experts say this is not just a problem of long hours. Amedical educator in the state of Illinois has worked with medicalresidents. Paul Rockey says medical residencies today are moredifficult than they were in the past. This is because patients donot stay as long in the hospital as they once did. Doctor Rockeysays this change puts a lot of pressure on young doctors to learnquickly from their patients.
Doctor Rockey says the difficulties of modern medical educationmay be great. But he says young people get great satisfaction inseeing themselves gain the knowledge and experience to become gooddoctors.
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VOICE TWO:
This program was written by Jerilyn Watson. It was produced byGeorge Grow. I’m Steve Ember.
VOICE ONE:
And I’m Mary Tillotson. Join us again next week for anotherreport about life in the United States on the VOA Special Englishprogram, THIS IS AMERICA.