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Maybe July 1st in the hospital isn’t so dangerous after all.

 

Every year it’s the same joke.  ‘Watch out on July 1st!  It’s dangerous out there!  The new residents are starting!’

Fair enough.  Young appearing, freshly graduated physicians, medical degrees and stethoscopes in their trembling hands, have been unleashed in hospitals and clinics across the land.  That sounds a little scary given the enormous weight of their responsibilities.

Those new residents are indeed new to the world of medicine; but only in the sense that they are, at last, physicians.  In order to reassure everyone, it might be good to review what those students did to get their degrees and make it to those residencies on July 1.

They finished four years of university and scored very, very well.  They dedicated themselves to school work, to other learning experiences like shadowing or part-time jobs in the medical universe.  They were tested and tried over, and over.  They worked hard to earn lauditory, shining letters of reference. They endured numerous interviews.  They had resumes that would make many people weep at their own inadequacies.

Some of them had other lives before medical school. Perhaps as nurses, paramedics, firefighters, combat medics, soldiers, sailers, airmen, engineers, teachers; almost anything imaginable.

They then embarked on four years of medical school.

Let’s briefly break down the medical school experience.

The first two years of medical school involve ‘basic sciences’ and amount to about 25-30 credit hours per semester.  Per semester, in case you didn’t get that.  It’s a crushing academic load during which learning has been compared to ‘drinking from a fire-hose.’  Afteward, their ‘fund of knowledge’ is incredible.  I still remember things that rise from the depths of my brain for no obvious reason except that I was told, decades ago, that they were important.

It is intellectually, physically and emotionally exhausting.  Medical education, during the academic years, involves a lot of tests; and then tests afterward to enter into the second two years of clinical training and another test to go on to residency.

What about those clinical years during medical school? Well, according to a comparison chart at www.midlevelu.com/blog, the average medical student logs about 6000 hours of patient contact time.  For comparison, a nurse practitioner (during his or her education) has about 500-1500 hours and a physician assistant student gets about 2000.

Now, this is not to denigrate the education of NP or PA students.  But only to say that when we suggest that July 1 is a time of terror, a time of remarkable danger because the new residents are starting, we might want to step back and realize the amount of education and experience that they have already logged.

We don’t tend to say the same thing about new NPs or PAs, even though their experience is significantly less than that of the graduating medical student.  In fact, increasing numbers of people have a PA or NP as a primary care provider.

Yes, residents are still learning.  Yes, I was there and I needed supervision.  And as soon as I finished residency I still felt frightened.  If I’m honest, I’ll tell you that 26 years into my practice (after residency) there are still days I wish I could have my old faculty members nearby.

But let’s give credit where credit is due.

The new residents, God bless ’em, have endured a lot, know a lot and care a lot.

Maybe, looking at the numbers, July 1 isn’t as dangerous as we thought it was…

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