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Comment by munherty | Hacker News Reader

Never understood why this doesnt get any press. Its absurd

It gets press, but it also a legitimate training technique in many fields. There is something to be said for living and breathing nothing but your job for a period of time. Stress and the ability to perform despite stress is also something that must be learned through experience. Doctors, attorneys, the entire military ... the juniors are run through a few years of long hours and horrible conditions. The downsides have to be weighed against the training value.

You still need sleep to form long term memories and make good decisions. Sleep deprivation is inhumane to the students and deadly to patients. There is no excuse.

You do realize that this isn't the entire training scheme? This is one stage of a multi-year process, starting long before med school. The most effective thing for patients would be to never be treated by trainee doctors but that isn't a practical option.

Yes. What's your point? Hopefully it's not that since patients are going to be treated by students, we may as well give up and have them treated by sleep-deprived students, or that sanity in one phase of the training process excuses insanity in another. But if you're not trying to make one of those arguments, I don't know how your comment is relevant.

The military is trying to mold you the same to make you replaceable and obeisant. Doctors don't need to be all the same.

Replaceable and obeisant? You've watched too many movies. Skills learned while under stress will be with you when you are under stress again later. A doctor is trained under stress so that in the future, when their patients are about to die in front of them, that they react as trained. A doctor will see more blood, more death, than most soldiers. The parallels in stressed training are not insignificant, and have nothing to do with obedience.

That's just not true. Being trained in a relentlessly stressful environment means that you're less likely to be creative, thoughtful, and empathetic in the solutions you come up with. It can also lead to learned helplessness -- a sense that things must be done the way they've always been done, because there's just not enough time and space from others to do things properly.

During residency they are dealing with patients dying in front of them. The stress is already there. I don't see why being sleep deprived is a benefit.

Basic training is literally about making them think and act certain way. It is literally about them all teaching exactly same set of super basic skills so that the soldiers are replaceable by the end by each other. There is reason why soldiers personality changes after basic training (that is what their families and partners say).

More complex skills are not taught in basic training, but later in specializations.

Under stress and duress and lack of sleep, people learn less. Moreover, while soldiers do in fact have to work in difficult physical conditions in action, doctors don't.

And I am not even sure what death on itself has to do with it. Conditions of encountering it are incredibly different in both professions.

“...Moreover, while soldiers do in fact have to work in difficult physical conditions in action, doctors don't. And I am not even sure what death on itself has to do with it. Conditions of encountering it are incredibly different in both professions.”

Try working in an inner city ER at night when it can often feel very similar to a war zone. Instead of sandbags and soldiers with rifles we’re surrounded by bulletproof glass and police officers.

That is nonsense argument. Doctors don't sleep in barracks or on grass, they go home to families. They eat what they choose to eat. They don't dig latrines. They don't have periods (days) of boredom full of made up work combining with short intensive assignments. They can leave the job.

Soldiers are not surrounded by bullet proof glass nor by police officers.

Gets lots of press. Google doctor interns lack of sleep for a litany of deeply-researched news articles.

Hospitals are being privatised and private universities dominate medical education. Where’s the political pressure point?

It gets press but only so many ways to report the same story for years on end.

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