A few weeks ago we read once again that our young colleagues in the hospitals have to work sixty hours a week despite the labor law and are thus pushed to the edge of their capabilities.
A chief physician recently told me that within a year, two residents had left because of burnout. Whether this news makes me wonder if we are admitting the right fifth of applicants to medical school. The skills that are asked for with today’s test must certainly be present. However, the test does not indicate whether the applicant has the robustness required to actually practice medicine. After all, it is astonishing that 25- to 35-year-old physicians are no longer able to temporarily work more than fifty hours per week.
In the future, there will almost certainly be too few working physicians. Demand for physician services will also increase as populations live longer. The work pressure will therefore increase excessively, and future colleagues will be challenged, work-life balance or not.
In 2013, 5367 young people in Switzerland registered for the aptitude test, 693 of whom are expected to sit for the medical state examination. The numerus clausus for studying medicine has been in place for 14 years. It was shown that the number of dropouts has been very low since the introduction of the test. In my opinion, however, the degree should not be considered in isolation. We have learned in medicine that the benefit of an antihypertensive should not be measured by the antihypertensive effect alone, but that the reduction in morbidity and mortality must be assessed. So if we train intelligent, theoretically socially competent people to become doctors, they should also be able to perform above average. So they should additionally be physically and mentally robust. In business and industry, 30-year-old women and men who assume responsibility are often on the job for sixty to seventy hours a week, performing tasks that are intellectually and socially extremely demanding and responsible in some cases. Many of them start a family between the ages of 30 and 40.
Conclusion: Today’s school- and head-heavy aptitude test needs to be supplemented. Ideally, prospective students should also undergo a physical and psychological aptitude test in a professional assessment center. Of course, the requirements would have to be adjusted in the event of any physical limitation.
Study places will remain limited, because clinical training positions cannot be created without limitation, even with large financial resources. We are therefore well advised to train those young people to become doctors in the future who will be physically and mentally capable of successfully completing their studies and later treating our population with human and professional competence under increased work pressure without themselves suffering any harm.
Cordially, your
Josef Widler, MD
HAUSARZT PRAXIS 2014; 9(5): 1
