Resident doctors have an important role in patient care. Although still in training, they are expected to provide a high standard of care under the supervision of experienced physicians. Residency training, which is mandatory to practice as a physician in the United States, aims to prepare doctors for the provision of quality care. The Accreditation Council for Graduate Medical Education (ACGME) launched an initiative called the Outcome Project in 1998 to assess the effectiveness of residency training programs and to improve the standard of care delivered by residents. Research has shown that quality improvement initiatives have a positive impact on patient outcomes, but a key question that remains is whether patient care is affected by residency training.
A systematic review published in BMC Medicine by van der Leeuw et al. addressed this question, showing that in most cases, patient care is equally good whether delivered by residents or experienced physicians. The study analyzed almost 100 articles, most of which investigated the level of experience of residents in relation to patient outcomes. The majority of studies showed that residents’ care resulted in similar patient outcomes compared with experienced physicians, when less experienced residents received adequate supervision.
The authors also found that progression through residency training had a positive effect on patient outcome, suggesting that training programs are effective, achieving their goal of preparing physicians to deliver quality care.
Whilst the studies analyzed in this systematic review largely give a positive message, a minority of results suggested negative patient outcomes as a result of resident care. The authors recommended that all residents be given adequate supervision, attention to competence and more time to complete operations, in order to ensure that quality care is given.
The results of this study should give patients confidence in resident care, and inform future decisions about how residency training should be carried out. As trained doctors play an important role in ensuring that residents are supervised properly, the findings should reassure doctors that training programs are effective, allowing the continued provision of high quality patient care.