MSR Practice Questions

Statement 1: Otherwise. In the last sentence of the Residency Association statement, the president says "Such working conditions are dangerous for both patients and residents; some serious mistakes have already been made and were caught only at the last minute by senior staff." The president, then, believes that the situation is dangerous and that there is at least the possibility of serious consequences from serious mistakes made by residents. In the last sentence of the Hospital Board statement, the spokesperson says "there is always an experienced physician on hand to verify the diagnosis, take over the procedure, or otherwise correct any potential errors" made by residents. The spokesperson, then, believes that there is an oversight system in place that will "correct any potential errors" – in other words, there is not the danger of lasting harm due to a resident's mistake. (Note that the spokesperson doesn't claim that the licensed physician won't make mistakes, but the question asks only about lasting harm caused by residents.) Statement 2: Both Agree. The Residency Association president explicitly states that residents have averaged 17.5 hours during the past month, so the president does believe that residents are working more than 8 hours during a 24-hour shift. The Hospital Board spokesperson says that "residents are not expected to work 24 hours in a 24-hour shift, nor anywhere close to that" but also that "if residents choose to participate in many routine activities that can ably be handled by the nursing or medical staff, that is the residents' choice." In other words, the spokesperson is acknowledging that it is possible for a resident to work long hours… if he or she chooses to do so. The two parties, then, both agree that residents may work longer than 8 hours during a 24-hour shift. Statement 3: Otherwise. The Hospital Board spokesperson states clearly that "until someone has finished the residency, he or she is not, and cannot reasonably be considered, a licensed physician." The Residency Association president provides only indirect evidence that "Residents are responsible for all of the licensed physician tasks, including intake, the ordering of tests and labs, diagnosis and treatment, including surgery" (emphasis added). The spokesperson clearly states that no one can be considered a licensed physician until the residency is complete. We might speculate either that the president disagrees or that there is not enough evidence to decide whether the president disagrees. Either way, the correct response is "otherwise."

Statement 1: Cannot Infer. The Residency Association indicates that the residents are assumed to work 1/3 of the 24-hour shift, or 8 hours, but the president does not claim that residents should not work more than that amount. They claim only that they work too much. We can infer that they think they should work less than 17.5 hours, but we do not know what they think of an 8-hour cutoff. Likewise, the Hospital Board never indicates a specific time beyond which residents should not be able to work. Statement 2: Both Accept. As part of their argument, the residents complain that their working conditions are dangerous and that, as a result, serious mistakes have been made. We can infer, then, that the residents believe the hospital is responsible for setting reasonable working hours in order to minimize or prevent errors made by residents (among other goals). The Hospital Board indicates that "when a resident" is working, "there is always an experienced physician on hand" in order to "correct any potential errors." The board, then, also believes that the hospital is responsible for minimizing or preventing errors made by medical residents. Statement 3: Cannot Infer. The residents state that they "are taken advantage of terribly" and cite the fact that they are "undermined or treated poorly by senior doctors – sometimes when patients are present" as one piece of evidence. The residents, then, agree with this statement. We might surmise that any ethical hospital board also would not want doctors to treat medical residents poorly when patients are present (or at any time!), but the Hospital Board's statement never addresses this aspect of the resident's complaint. We do not know how the board feels about this issue.

According to the first tab, the residents are assumed to work "one-third of the hours" in an assigned shift. If the shift is 24 hours long, then, a resident is assumed to work for 8 hours. In that case, the hourly wage would be $105 / 8 hours = $13.125. Rounded to the hundredths place, this is $13.13. The resident indicates that the average time worked over the past month was actually 17.5 hours. The hourly wage in this case would be $105 / 17.5 hours = $6.00. The difference between the two wages is $13.13 - $6.00 = $7.13.