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放射科住院医师兼职的性质和范围。

The nature and scope of moonlighting by radiology trainees.

机构信息

Department of Radiology, University of Washington, Seattle Children's Hospital, 1959 Pacific Ave NE, Box 357115, Seattle, WA 98195, USA.

出版信息

Acad Radiol. 2013 Feb;20(2):249-54. doi: 10.1016/j.acra.2012.08.004. Epub 2012 Sep 12.

Abstract

RATIONALE AND OBJECTIVES

The practice of moonlighting by trainees is a longstanding controversy; however, the resident point of view remains distinctly underrepresented in the radiology literature. We report the resident perspective on the moonlighting practices of radiology trainees.

METHODS

Survey data were collected from resident members of the Association of University Radiologists representing 84 training programs in the United States to assess their routine and extracurricular clinical responsibilities. Descriptive statistics were used to analyze these data.

RESULTS

Moonlighting is practiced by radiology trainees at nearly three-fourths of the programs represented in this survey. Interpreting diagnostic imaging (85.5%) and monitoring contrast administrations (72.6%) are the most common duties performed. Twenty-one percent of moonlighting trainees perform procedures (excluding diagnostic fluoroscopy) in their extracurricular positions; of these, most (61.5%) are without attending supervision. Most trainees that moonlight spend 1 to 10 hours weekly doing so while averaging a 59-hour workweek at their primary jobs.

CONCLUSIONS

The clinical duties of moonlighting trainees may be more diverse than has been previously recognized. Although major discrepancies between overnight radiology trainee interpretations and attending final interpretations have been shown to be infrequent, the consequences of trainees performing procedures and monitoring adverse contrast reactions without attending supervision are unknown. The financial and professional benefits of moonlighting must be weighed against the potential for harm. Our data suggest that most moonlighting radiology trainees operate within the Accreditation Council for Graduate Medical Education-mandated 80-hour weekly work limit; the mandatory 8-hour break between shifts and 24-hour continuous duty limit may pose logistical challenges.

摘要

背景与目的

住院医师兼职是一个由来已久的争议问题;然而,放射科文献中明显缺乏住院医师的观点。我们报告放射科住院医师对住院医师兼职实践的看法。

方法

从代表美国 84 个培训项目的美国大学放射学家协会的住院医师成员中收集调查数据,以评估他们的常规和课外临床职责。使用描述性统计数据来分析这些数据。

结果

在这项调查所代表的近四分之三的项目中,放射科住院医师都有兼职。最常见的职责是解读诊断影像(85.5%)和监测对比剂的使用(72.6%)。21%的兼职住院医师在课外职位上进行操作(不包括诊断透视);其中,大多数(61.5%)没有主治医生的监督。大多数兼职住院医师每周兼职 1 到 10 小时,而他们的主要工作每周平均工作 59 小时。

结论

兼职住院医师的临床职责可能比以前认识到的更加多样化。虽然已经证明夜间放射科住院医师的解读与主治医生的最终解读之间存在重大差异的情况很少见,但住院医师在没有主治医生监督的情况下进行操作和监测不良反应的后果是未知的。兼职的经济和专业利益必须与潜在的危害相权衡。我们的数据表明,大多数兼职放射科住院医师的工作时间都符合研究生医学教育认证委员会规定的每周 80 小时工作时间限制;两班之间 8 小时的强制休息时间和 24 小时连续值班时间限制可能会带来后勤挑战。

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