Fireworks, champagne toasts, sparkly hats, and the ball drop are all items that we conger up in our minds as we think of the New Year. For the majority of the world, January 1st represents the transition from one year to another on the calendar. New resolutions are made, and there is a global fresh start. However, for those of us in the medical field, there is another new year that we celebrate. In addition to joining with the world to usher in January 1st, in our world, July 1st is a hallowed and quietly noted transition date.
Every July 1st in medical training facilities across the United States, new physicians enter residency training and those who have completed their training requirements exit to enter the work force as attending or independent physicians. There is little national fanfare about this monumental transition but, among ourselves we prepare, we celebrate and mark this period in many different ways.
As we recently celebrated this annual date, there were different responses evident from my survey of medical professionals on social media. Many embraced this transition with enthusiasm and excitement. There were others who had more of a cynical or apprehensive approach, while still more approach this date annually with caution. We have read the studies that July is a “deadly” month in the hospital as new interns begin, and everyone transitions to new positions within the hospital system. Perhaps this perspective robs us of acknowledging all the positive aspects of this special date. There are constant initiatives to address the July workforce changes, calls for closer supervision of new interns, we’ve had modifications to resident work hours, discussions about burnout and are hopefully moving in the right direction to make July safer. So perhaps we can reclaim some of the optimism of this date.
Let us not lose sight of how incredible this new year of medicine really is. Much like the global celebration in January, this is a new beginning. Rather than approaching these new trainees with skepticism we should embrace them. Once upon a time, many of us were in these very same shoes. One magical night, we transitioned from holding a degree with a substantial fund of basic medical knowledge, into a clinical decision maker with some level of autonomy. Many of us can remember the butterflies and anxiety, perhaps even fear of those first few days as our confidence built.
What we need to remember is that these new trainees breathe life into our health care system. While those of us who are seasoned can be jaded, unappreciative of what we see as routine, find ourselves “doing what we always do because we have always done it,” and new residents are not. They are excited to be here, hold a pager and be a part of the medical team. The presence of trainees calls us to do more, to explain more and question, to be an example, and maybe to recall the optimism that we once began the journey with.
So let me share three reasons why we should celebrate as we approach the July 1st transition annually:
1. Our noble profession continues. As new trainees enter our hospitals and those who completed residency exit for the workforce, we increase the number of physicians to take care of our elderly, children, to perform surgery. This is vital; our profession needs new blood to continue. So that the burden is lighter on those among our ranks, so our patients continue to receive quality care and have provider options. The only way to address physician shortage is to continue to encourage and celebrate the practice of medicine.
2. New residents have eager minds and eager hearts. With the exception of outliers, most new residents have a desire to make a positive impact when they hit the hospital grounds. They are eager to learn, to be great at their craft. Finally, the moment they have been preparing for years, sometimes over a decade has arrived. To be called Doctor is an honor which they desire to live up to. They are open and receptive to knowledge, and they are still largely compassionate and willing to listen to patients. They have not been worn down by the medical system. We should nurture and celebrate this.
3. A fresh start for the health care system as a whole. July 1st usually marks the opportunity for change in the way we approach education of residents and ourselves. For example, at academic institutions grand rounds sessions take a hiatus during the summer months and resume late in the summer or fall with the entry of a new class of residents. The arrival of the new residents is often a time to revisit what works, try something new protocols and innovate how we practice and teach.
So perhaps next July 1st, we can all take a moment to pause and celebrate this special time. Think about the good this transition breathes into our hospital systems. In passing a new intern give a smile or word of encouragement to help him or her along the way.
N. Bande Virgil is a pediatric hospitalist.
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