I’m a resident in Internal Medicine at the University of Toronto and, on July 2nd, I started my first shift as a doctor. It was a 26-hour shift that included a night jam-packed with running between sick patients while thumbing through my textbook to make sure I didn’t miss an important investigation or treatment. As a resident, the amount of time I spend in the hospital is rarely under my control. The week is often long, occasionally upwards of 80 hours. My training program sure knows how to throw us straight into the deep end.
The transition from medical student to resident feels a little intense. I didn’t get any smarter from one day to the next, but now have an enormous amount of power and responsibility. Sure, there are residents with a year or two more experience just a phone call away. But when crap hits the fan and a patient gets acutely ill, I hope I’m competent enough not to make critical mistakes. Part of the learning curve is developing clinical judgement and I’d really prefer not to do that at the expense of a patient’s health.
I swear, my anxieties aren’t baseless. Some staff physicians and nurses nervously chuckle about “The July Effect,” a phenomenon that suggests hospitalized patients experience higher rates of morbidity and mortality as a result of all those new MDs starting their residency at the same time. Fortunately, recent research suggests the effect is likely not that dramatic, but it’s hard to deny that patient care may not be optimal in July. Mistakes are more likely to get made. Issues can get missed. Good care just takes longer to provide.
With all of this weighing on me, I made an explicit decision not to fast this Ramadan. [Read more...]