In Let Me Heal, prize-winning author Kenneth M. Ludmerer provides the first-ever account of the residency system for training doctors in the United States. He traces its development from its nineteenth-century roots through its present-day struggles to cope with new, bureaucratic work-hour regulations for house officers and, more important, to preserve excellence in medical training amid a highly commercialized health care system. In the making of a doctor, the residency system represents the dominant formative influence. It is during the three to nine years that medical graduates spend as residents and clinical fellows that doctors come of professional age - acquiring the knowledge and skills of their specialty or subspecialty, forming a professional identity, and developing habits, behaviors, attitudes, and values that last a professional lifetime. Let Me Heal provides a richly contextualized account of the residency system in all its dimensions: its historical evolution, educational principles, moral underpinnings, financing and administration, and relationship to the broader culture. It focuses on the experience of being a resident, on how that experience has changed over time, and on how well the residency system is fulfilling its obligation doctors. Most important, it brilliantly analyzes the mutual relationship between residency education and patient care in America. The book shows that the quality of residency training ultimately depends on the quality of patient care that residents observe, but that there is much that residency training can do to produce doctors who practice in a better, more affordable fashion--from dust jacket.
Antecedents -- Johns Hopkins and the creation of the residency -- The growth of graduate medical education -- The American residency -- The life of a pre-World War II House Officer -- Consolidating the system -- The expansion of the residency in an era of abundance -- The evolving learning environment -- The life of a post-World War II House Officer -- The weakening of the educational community -- The era of high throughput -- The era of accountability, patient safety, and work-hour regulation -- Preserving excellence in residency training and medical care
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