Dear Colleague,

The event helped me to remember that I had many of the same questions when I was a first- and second-year medical student. I would ask the students in the year ahead of me numerous questions, mostly because those students were all I had access to for information. In retrospect, it would have been ideal to have had easy access to residents for their perspectives, but it was difficult for me at that time, because my interactions were limited to weekly sessions with the residents and the various medical specialty interest groups. It would have been useful to have had a forum for discussing information about clinical years and lifestyle differences.

These thoughts lead me back to the questions asked at the panel and how the aspect of lifestyle differences among the residency programs has become one of the driving forces in a medical student’s choice of career. These differences among residencies influence some students to choose specialties in which the work-hour demand is less intense.¹ Also, there is an ongoing effort to improve the work-hour schedules to which residents adhere in all specialties. This movement is being fueled by data gathered in the past few years that demonstrate the benefits experienced by residents and patients alike when the work hours of residents are limited.^2,3

The medical students at the residency panel found these facts interesting. But knowing this, how could we use the information to improve the situation?

I told the students that, in general, many medical students and residents, as well as some practicing physicians, do not develop real-world experience in a work environment as a consequence of progressing directly from high school to college to medical school and then to training. They may become comfortable with the idea that their administrators are working on their behalf for their best interests. This belief is difficult to shake when one transitions between levels of education. There are some hospitals where decision-making is based more on a financial “bottom line” than on the well-being of their medical students, residents, and physicians. As a consequence of inexperience, many of us may not have the knowledge to effectively evoke changes in a hospital system that would better our residency years.

At this point, I asked the students if they knew where to go to become educated on these topics and to help promote change in these issues. In the pause after my question, I gave them the answer—the American Medical Association (AMA). The AMA is the largest organization of physicians in America. It is through membership and participation in this respected organization that we can begin to pursue the discovery of the best solution to these and other issues. Empowering ourselves to effectively evoke positive changes in the work environment is a necessary part of our profession. Such positive changes will create improved working and learning environments and lead to better patient care.

The students were excited by what they heard. They already knew that if they were interested in a particular specialty, they could join that specialty society. But to tackle the topics we discussed in the residency panel, there is no better forum than the AMA. I explained to them that the AMA is made up of groups that represent medical students, residents and fellows, and physicians, and that allows individuals to deal with issues pertinent to their current level of training as well as to the larger issues affecting all medical professionals and patients.

I told the students that the future of health care is our responsibility. The AMA affords us a forum for improving the status quo. I feel fortunate to be part of this great organization, and I encourage all current and future physicians to join.

Alexander Llanos, MD
Member-at-Large American Medical Association- Resident and Fellow Section

References
1. Dorsey ER, Jarjoura D, Rutecki GW. Influence of controllable lifestyle on recent trends in specialty choice by US medical students [published correction appears in JAMA. 2003;290:2666]. JAMA. 2003;290:1173-1178.

2. Lockley SW, Cronin JW, Evans EE, et al, for the Harvard Work Hours, Health and Safety Group. Effect of reducing interns’ weekly work hours on sleep and attentional failures. N Engl J Med. 2004;351:1829-1837.

3. Barger LK, Cade BE, Ayas NT, et al, for the Harvard Work Hours, Health, and Safety Group. Extended work shifts and the risk of motor vehicle crashes among interns. N Engl J Med. 2005;352:125-134.

American Medical Association
- Resident and Fellow Section
2005-2006 Governing Council

Joe Craft III, MD, Chair
Sunny Ramchandani, MD,
MPH, Chair-Elect
Kelly Caverzagie, MD, Vice Chair
Douglas Che Miller, MD, Secretary
David Rosman, MD, Delegate
Adam Levine, MD, Alternate Delegate
Alexander Llanos, MD, Member-at-Large
Michelle Nichols, MD, Member- at-Large
Samantha Cramoy, MD, Resident Trustee
Julie Snelling, Director
Department of Resident and Fellow Services

“Code Blue” is prepared by the Resident and Fellow Section of the AMA. Unless specifically indicated, its articles and opinions do not necessarily reflect the policy of the AMA or the opinions of the editors or the publisher of Resident & Staff Physician. This news­letter is contained in Resident & Staff Physician solely as a service to residents.

The journal is not in any way involved in deciding the content of “Code Blue.” All questions, suggestions, or requests for additional information should be sent to the AMA Department of Resident and Fellow Services, 515 North State Street, Chicago, IL 60610, or phone 312/464-4751. The Amer­ican Medical Association-Resident and Fellow Section (AMA-RFS) is this nation’s strongest voice for residents and their patients. Visit our Web page at www.ama-assn.org/gorfs To join or renew your membership, call the AMA-RFS at 800/AMA-3211.