Evolution of Resident House Staff in the Age of Libby Zion

After the Libby Zion case in 1984, major changes to the structure of residency programs were implemented to improve patient safety and promote supervision for doctors in training. The large focus of these changes has been centered on the 80-h work schedule. As a response to the changes in work hours, many attending physicians have shown apprehension to the quality of training in the post-Libby Zion era. Often not addressed, around the same time of these changes, the breadth of knowledge needed to be proficient in various fields rapidly increased. Furthermore the use of electronic medical records shifted house staff away from the bedside. This chapter focuses on the history of residency programs, the Libby Zion case and how the future of training doctors depends on appreciating how technology and flexibility of programs can improve the quality of training programs.