July 1st is approaching and with it comes the transition of close to 30,000 positions involving resident physicians and those doing clinical fellowships. There was a point where all that was required was to show up. It was wise to bring your toothbrush if you might be on call the first day.
The world has changed. There are hours of training for the proliferation of electronic medical records. Many training programs may be sited at multiple hospitals and clinics, each having its own unique and quirky medical records. There on line courses in privacy, infectious diseases, safety, harassment, cultural sensitivity. There are security cards, keys, pictures, and an endless series of site specific details.
The July 1 disruptions were famous even before the new challenges the new complex transitions provide. Housestaff always carry some real patient care load responsibility. While concern has been voiced about duty hours and their effect on safety, imagine how the yearly workforce disruption should be viewed.
Given the complexity of onboarding all these candidates and requiring them to transition and start all at the same time, why do we continue to do business this way? Would it not be wiser to stagger transitions? What other business conducts itself this way? I can think of none and for good reason.