Changing the Culture: The Ides of July

Every year in the United States when July hits, just like the July before, a hush comes over the medical community from healthcare providers to lay people alike: Don’t go to the hospital! There’s brand new doctors starting their medical training!

(Just to recap this for non-medical people: The path to medicine is Medical School after which someone is a Doctor, to Internship and Residency in which a Doctor specializes in a particular field (eg: a Doctor becoming a Pediatrician), to optionally a Fellowship, in which a Specialized Doctor subspecializes (eg: a Pediatrician becoming a Pediatric Cardiologist), to Attending – full-fledged and at the end of formal training.)

Admittedly, I’ve said the same thing before and it stems from the basic North American timeline for medical training whereby every year at the beginning of July, a new cohort of medical students completes their graduate training and are granted the title of Doctor as they embark on their medical residency training. This first year of post-medical school on-the-job training, always referred to as an Intern year, is fret with a steep learning curve and is the first time that a Doctor starts to make and carry out decisions in regards to other human lives. So, naturally, over time it’s been passed down that this is a dangerous time to be in the hospital with someone that has just started their learning. Most people don’t indulge the idea of being a “Guinea pig.”

Recently, I’ve seen a lot of movements on Social Media towards countering this idea that point out some important things: Yes, it is the first time that an Intern Doctor is called a Doctor; but, this is after over 20 years dedicated to science and medicine, thousands and thousands of hours in studying (I clocked at least 7000 hours at a coffee shop that I can recount, probably more) and careful training under prior Interns, Residents, Fellows and Attendings. Not only have we dedicated our entire lives to this point to becoming Doctors, but there are multiple levels of oversight by the previously mentioned hierarchy and for most Interns an innate fear of messing up, and thus usually a higher attention to details. As an Intern, although study becomes reality and decision-making becomes more tangible, there are eyes watching from all over for potential mistakes and “teachable” moments. By in large, being in the hospital in July actually means the oversight lends itself to bigger teams of doctors visiting and multiple exams, double-checks and attention. This also means new Fellows, which, although not new doctors anymore, are still learners along the way. Often times the experience and background they bring is differing in training and can lead to even greater collaboration and amalgamation of knowledge. Still, not without oversight and hopefully humility.

We have all been there and every learner had to start somewhere. At the least, the lifelong memory and importance of a patient on the affect of a Doctor and their longterm practice, countenance and perspective can be fundamental in producing the Future. So, perhaps it is time to change the discussion of July and to look forward to the new blood that will go through fire to become seasoned blood.

To the doctors, nurses, therapists, secretaries and consultants, hopefully eventually we can change the way we talk about July and our New Residents. Support them, they will make mistakes, but all Attendings once started out this way. Your voices echo throughout the hospital and much farther.

And most importantly don’t forget… July also means Brand New Attendings.

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