Partha Kar

Developing a positive attitude to new doctors

So we can now all breathe a sigh of relief, Black Wednesday has come and gone. Damn those newbie doctorskilling all those hapless folks being admitted, and shame on the NHS for once again failing the public!

Well, the papers have been all over it, and it’s interesting how few in the medical community have actually said anything in protestation. So, is it true?

The evidence traces back to a study done by researchers at Imperial College London in 2009 entitled: “Early in-hospital mortality following trainee doctors’ first day at work”. They reviewed NHS hospital statistics from 175 hospitals over the period 2000 to 2008; comparing admissions from last week of July and the 1st week of August.

All patients were followed up for a week and taking all variations into account, there was a 6% increase in the first week of August compared to the last week of July. The 2009 study, however, did not include a breakdown of each patient death. As such, it gives no indication of the cause of each death and is impossible to see whether this was due to the error of a junior doctor.

The study also acknowledges that it could not ensure that the only difference between the two cohorts was the presence or absence of new medical graduates. There were other factors, such as the severity of the ailment or disease, which were not adjusted – and in fact the researchers themselves at no point blamed new junior doctors for the increase in death rates. But, hey, has that stopped anyone from pointing the fingers at the newbies? Nope, not a jot.

The evidence is there – so let’s not rail against it, but could it be because the new folks lack support?

“Killing season”- screamed a paper headline – and it made me wince. I have been a junior doctor and probably worked more hours than the current crop per week – but I think we had exactly the same intensity and passion. I have been a consultant now for close to four years and have I met junior doctors who are slackers or look on this work just as a “job”? Of course I have. Do these guys have the same inclination to learn? Yes. It’s not their fault that the working hours prevent them from attending teaching.

Here is an example. Our junior doctors are not allowed to stay after a night shift because it would breach European Working Time Regulations. It used to be one of the best times that you learnthow on earth are you supposed to know what you did in the middleofthenight was right or wrong? But, no, evidently the portals to Hell will be opened and the undead shall inherit the earth, so they have to leave. Would the juniors love to stay back even for halfanhour and learn? You betcha.

When I started as a baby doctor, I met the most amazing guy ever. His name was Azman Ibrahim. He was only a Senior House Office but boy, wasn’t he always there for his juniors. I still remember a particularly hard day – when every single time I had tried to draw blood, I had failed. It was busy, I felt like a failure – and this guy, in the middle of everything, brought me a cup of coffee, sat me down and said he would stand with me for the next set of bloods to be done. It took him 2 minutes.

A lesson was drilled into me, never, ever abandon your juniors. Go that extra bit, they will give you much more than 100% when the crunch comes. These fresh faced folks need support – not to start their careers with the press labeling their first day at the office as “Black Wednesday”.

What a load of rubbish and how demoralising can it possibly be? An evidence base which could have been as much the fault of the senior but nope, its all the fault of the juniors, isn’t it?

Its maybe our issue that we haven’t made the provision in our job plans for those initial weeks of juniors‘ careers, where we should stand next to them. How many of us as consultants have planned to make sure as a team we do something different to make sure there is extra support around at this time of the year? If we know the mortality rate is worse, then the collective responsibility is ours to solve it, not shrug our shoulders and wonder how “junior doctor standards are dropping”.

So, for those who have started in a new job, look ahead, take a deep breath and get into the thick of things. It’s not a Black Wednesday. It’s the day when you begin a life where you help others. It’s an amazing day, this day should always be known in your life as the Wonderful Wednesday, or for those who started on the 1st August 2012…Wonderful “Wiggins” Wednesday, a day of positivity and happiness.

Ladies and gentlemen, welcome to the NHS and may you all do fantastically well in your careers. There is nothing, absolutely nothing negative about that. Amen.

Read more at Partha Kar’s personal blog.

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2 Responses to “Developing a positive attitude to new doctors”

  1. Malcolm Morrison says:

    Well said!

    And who was it that ALLOWED the EWTR to come into force and apply to juniors? Our ‘leaders of the profession’! And they did not think that they applied to them too!

    NO profession can work to such rigid ‘rules’ – which were really designed to protect workers ‘on the shop floor’ of factories (or offices) from being exploited by ruthless employers.

  2. privatepracticeexpert says:

    Have you noticed how many consultants go away on annual leave during in the first week of August?

    Just an observation….

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