Changes in residencies over the years

My husband is involved in fellowship training, and as such, he gets some graduate medical education journals which I will on occasion flip through. The most recent issue of the Journal of Graduate Medical Education caught my eye because of its focus on burnout. A particularly interesting editorial that addresses the changes in residencies over the years.

I was surprised to find out that there have been discussions about the exploitation of residents dating back to 1940. More surprisingly, though, is that the complaints of abuse did not surface until after World War II.

The article describes that residencies at that time were quite prestigious and difficult to obtain, so there was a sense of gratitude for the position. Additionally, there were high quality teaching activities, residents knew faculty well, and there was a lot of esprit de corps among the residents. For example, residents lived in the hospital (hence the name house officer) and recieved low pay and did not get married during residency, but everyone did it that way. Over time the balance between service and education may be shifting, and the expectations of the trainees is certainly changing.

I think more trainees now feel taken for granted. There is an expectation by some that they will not do any internal medicine in an oncology fellowship, which I find ludicrous. But the point the trainee is trying to make is well taken: I don't feel like I am learning anything new here. My job is to find those new teaching moments, and to get to know the fellows better on a personal level so that they know how vitally important they are to us.