It is interesting to me that everyone seems to be crying about how many hours residents are working ("The secret lives of physicians," Modern Physician, October 2005, p. 7). It's not as if things are going to change dramatically after residency. My workweek ranges from 60 to 80 hours. One weekend in seven I am on call, which starts at 5 p.m. Friday and ends at 7 a.m. Monday. During that time I am paged countless times. I end up with eight to 16 admissions, plus rounds with my own patients and those of other doctors in my call group. After that, my workweek begins again. Our local residency program closes down if it's overloaded. My partners and I don't get that luxury.
M.A. Mitchell, Osteopath, Wichita Falls, Texas
It's bad here, too
While this article, "Poorer nations suffer physician 'brain drain,'" (Modern Physician Stat, Oct. 28, 2005) does not paint a pretty picture for the physician workforces of some Third World countries, between its lines is also a dismal picture for the physician workforce in the United States. A related article in an earlier edition indicates that the freshman classes of U.S. medical schools are 2% greater than in previous years, however, applications to medical schools have been on a decline. Consequently, competition for applicants is less robust than in the past, and the best and brightest undergraduates may be seeking careers in other professions. Hence, the U.S. has a brain drain of a different kind.
The source of this brain drain is that it is less desirable to become a physician. In addition, although foreign medical graduates may betray their duties to the homelands that subsidized and invested in the costs of their educations when they leave to practice in a more developed nation, in an ironic turn, the U.S. betrays the duty it owes to its own citizens who want a career in medicine. This is because no one, other than medical students themselves, pays for the costs of medical education in the U.S.
Howard N. Smith, M.D., Washington, D.C.