The Guidewire
A letter to the new class
To the doctors who just walked in

July 1 Is the Best Day
to Come to the Hospital

The new doctors just started. The data says no one dies more in July. The joke we tell new doctors still does damage.

By Peter Sorensen, DPM

Look at who just walked in. They spent years getting here. Thousands of hours, real sacrifice. And they made it. They are not cynical. They have energy. They want to meet the patient. More incredibly, they want to TALK to the patient! They still believe the work matters, and they are right to. That is the most alive medicine ever gets.

Then we greet them like a threat.

Every July the joke starts. Stay away from the hospital, the new interns will get you killed. "Killing season." "Black Wednesday." We say it to their faces on the first morning of their careers.

Tell someone on day one that they are dangerous, and you start dimming the exact thing that makes them good.

That is how a passionate new doctor slowly becomes a burned-out, cynical, disgruntled internet forum poster. It has a name in medicine: moral injury. And it can start on day one, before they have done a single thing wrong.

And the scary story was never true.
5.98 M
patients in the largest study ever done. No July effect on death, on complications, or on readmission.

It pooled 113 studies going back to 1989. July came out the same as every other month. You are not more likely to be harmed because the calendar turned to July. The one thing that does rise is medication errors, and only where new residents work. That is a prescribing and cross-checking gap, and it is ours to close by putting more support around new doctors.

Zogg et al., Annals of Surgery, 2023 · Phillips & Barker, J Gen Intern Med, 2010.

So lift them up. That is the whole job.
  • Protect the energy they walked in with. It is the safest thing in the building.
  • Tell them exactly who to call at 2 a.m.
  • Check their orders the way you'd want yours checked.
  • Treat every question as competence.

You can't biohack the reps that build a clinician. They come from repetition and support, and both go further when the new doctor isn't braced to be blamed.

Come on July 1.
You'll be seen by someone who studied for years to be standing there, who still cares a great deal, and who is watched closely by everyone above them. I would take that any day of the year.
— Peter