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Excessive Work Hours of Physicians in Training in El Salvador: Putting Patients at Risk

  • Kenneth R Fern├índez Taylor
  • Published: July 17, 2007
  • DOI: 10.1371/journal.pmed.0040205

Reader Comments (13)

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Zombie-like State of Somnambulistic Awakeness

Posted by plosmedicine on 31 Mar 2009 at 00:12 GMT

Author: Sandra Carina Schou Holm
Position: Medical Student, 5th year
Institution: University of Southern Denmark
Submitted Date: August 11, 2007
Published Date: August 13, 2007
This comment was originally posted as a “Reader Response” on the publication date indicated above. All Reader Responses are now available as comments.

First I'll congratulate Kenneth for being the one who told the world the facts of how inhumane the interns' conditions are in El Salvador.

I was an exchange student attending classes and working shifts in Hospital San Rafael, San Salvador in August 2005. I must say that the everyday in the hospital came to me as a shock. The contaminated halls were overcrowded with patients, while a few white coats were running back and forth. Not only were the interns being forced into a state in which sleepiness and stress were the primary factors, but also the medical students (from 3th year) were taking shifts every 5th day. No intern can possibly be capable of continuously having a good grasp of the situation nor can a 3-6th year student by any chance treat patients with an adequate medical knowledge.

I recall several situations in which lack of staff and the excessive workload made a major impact on the patients' health and survival. Especially the delivery room occurred to me as obscure and out of law. There were so many women giving birth basically at the same time that the interns gave Oxytocin in an extremely early state of the deliveries while pushing on the women's' stomach- simply those things were happening because of stress and a silent hope of being able to sleep for a moment.

I was attending surgery with the other students from 4th year. We had classes and tutorial hours from 7AM to 4-5PM Monday to Friday plus working night shifts every 4th day. It was incredible tough compared to the way of studying and completely different from how it is to be a medical student in Denmark. Therefore I hardly dare to imagine how it must feel to an intern! How devastating it must be, when one isn't able to interact with patients without being in a zombie-like state of somnambulistic awakeness while a constant fear of being responsible for medical errors knocks inside one's forehead. I wouldn't even want my worst enemy experience such kind of insufficiency... Never has it been fair to the personnel nor the patients.

I sincerely wish that someone at least will pay attention to this year-long conflict and I hope to see some changes for all of You... I have You in my mind.

No competing interests declared.