Between the nerves, the unfamiliarity and the urge to impress, few people do themselves justice on the first day of a new job. When it comes to doctors starting out in emergency medicine, though, are patients' lives being put at risk? According to research from Imperial College London, the death rate among patients admitted to English hospitals on the first Wednesday in August — the day, traditionally, that newly graduated doctors take up their posts — was, on average, 6% higher than for those admitted the last Wednesday in July. An influx of new medical staff, in other words, just might be very, very bad for your health.

In the university's study, published Sept. 23 in PLoS One, the online scientific journal of the U.S. Public Library of Science, scientists analyzed close to 300,000 patients admitted to state-run hospitals across England on those two Wednesdays from 2000 to 2008. The health of the patients, who were split evenly between the July and August admission days, was tracked for a week. While there was little difference between the crude death rates for each seven-day period, when researchers controlled for the patients' age, sex, socioeconomic status and secondary medical problems, the odds of dying was found to be 6% higher for those admitted on the Wednesday in August. Among so-called medical admissions — all those not suffering from cancer or requiring surgery — the odds were 8% higher.

Even the "small but significant" discrepancy highlighted by Imperial's study doesn't point to a particular cause. It's possible that patients admitted on the days junior doctors began work were simply in worse health than those taken in the week earlier. Some hospitals may have been more reluctant to admit patients with less-serious problems on the days new staff started work, limiting the number of cases young medics had to deal with but increasing the concentration of acutely ill patients in the process. "So it may not necessarily be directly related to the quality of care," says Paul Aylin, an epidemiologist at Imperial College London and senior author of the study.

Aylin and his colleagues are keen to test the link further. One problem: tracking admissions for a longer period before and after junior doctors begin work might offer a more reliable sample; extend the monitoring period too far, though, and the two groups soon overlap. Plenty more for researchers to ponder, then — except those on their first day.

Hi eric0224_yu,

This is very interesting but is there a solution, new doctors have to have a first day sometime, so if it is purely nerves, poor performance on the first day how do you lead them into this better, they can't jump to the second day.

I wonder how many deaths are caused by complacency and doctors not washing their hands between patients, or even writing that nurses cannot understand. There is always room for improvement mate.

Cheers

not really. I think you will be okay. Maybe this might help,,
The best way to avoid problems with fruit flies is to eliminate sources of attraction. Produce that has ripened should be eaten, discarded or refrigerated. Cracked or damaged portions should be cut away and thrown away in the event that eggs or larvae are present in the wounded area.