Monday’s Musings-(Don’t Fear) The Interns.

Yeah, that is a riff on Blue Oyster Cult’s Don’t Fear the Reapers. While researching the song I realized that it was released in 1975. I also learned that it is a song about not fearing death. And if that is not the perfect hospital song, I don’t know what is.

July 1st is the start of the intern year for all of the medical students that graduate in May. They may be nervous on their first foray into, you know, actual medicine. To what they have gone from at least 8 years of college for. June 30th is when the previous year’s crop of interns graduates in residency.

It is also feared among the staff of the hospital.

And there are memes aplenty.

In the United States it is known as the July Effect. And in the UK they call it the Killing Season. The idea that a patient will have sub-standard care because there is a new intern is not borne out by the literature. It is just that medical type people are alarmed by what could potentially happen, not what actually happens. (Hughes, 2017)

But why?

The July 1st start for the interns is not to be feared. If they are left alone on their first month, without supervising doctors who are supposed to be teaching them, that is the flaw of the system, not the intern.

This is how the medical system grows doctors in the United States. It is a stair step approach. They begin on the lowest run. Internship is the first rung, followed by residency, however many years is required and it changes by specialty, and then fellowship, and then further fellowship in a more pinpoint direction, and then full fledged doctor. It is the rung above that is responsible to teaching and guiding the interns, along with a supervising doctor that all the residents and interns report tp.

Hey, doc, act your internship, not your residency doesn’t have quite the same ring. Some interns are cocky, finally freed from the shackles of their medical school bounds. This does happen because interns are people too. And people think they are smarter and better trained than they actually are. It doesn’t last long, though. A new intern figures out pretty quickly that there is still more to be learned, and other former interns, known as residents, are there to help them along the path.

But the impact on patients, on human life? Is minimal.

And intern season, is here and then gone.

Only for the next intern crop to rise.

Hughes E. (2017) July Effect? Maybe not. CMAJ. 2017 Aug 14;189(32):E1050-E1051. doi: 10.1503/cmaj.1095466. PMID: 28808121; PMCID: PMC5555760.

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