This Wednesday, thousands of medical students will walk onto NHS wards for the very first time.
The date – the first Wednesday in August – where young doctors begin to treat patients, has long been given a grim nickname: Black Wednesday.
The theory is that these inexperienced novice doctors are more likely to make mistakes – raising the risk of harm to patients.
Studies appear to back up the danger of Black Wednesday too. A landmark 2009 study by Imperial College London researchers, examining hospital admissions between 2000 and 2008, found the odds of death for patients admitted on the first Wednesday of August were between six and eight per cent higher than for those admitted the previous week.
Experts say that, in recent years, measures have been taken to mitigate the risks of Black Wednesday.
However, experts admit that the period can still be fraught with difficulties for doctors and patients.
They also warn that this year could be more disruptive due to the hot weather – and are warning some patients to stay away from hospital.
So, should you put off a trip to hospital tomorrow?
Experts say that there are many important aspects of being a doctor that cannot be taught at university, meaning medics starting on Black Wednesday will be learning on the job
First, it’s important explain why Black Wednesday happens.
Medics in the UK typically spend five years at medical school before entering the profession as resident doctors – previously known as junior doctors.
But experts say that there are many important aspects of being a doctor that cannot be taught at university, meaning medics beginning their new roles on Black Wednesday will be learning on the job.
‘There’s a lot that new resident doctors need to learn in their first few weeks,’ says Professor David Strain, a diabetes expert at Exeter Medical School.
‘For example, you aren’t taught in medical school how to lift patients and put them into a bed. You also need to go through infection control training, to limit the risk of spreading bugs through the wards.
‘You’ll also need to have refresher courses of the really important skills, such as resuscitating patients, which these doctors have not performed in real life before. Reading a textbook is very different to doing the job.’
Experts claim that, over the years, Black Wednesday has changed, largely due to safety concerns over the changeover period.
Since 2012, resident doctors have been required to undergo a four-day shadowing course, where they watch qualified medics go about their job on the wards.
A landmark 2009 study found the odds of death for patients admitted on the first Wednesday of August were between 6 and 8 per cent higher than for those admitted the previous week
‘We’ve had our trainees in since last week,’ says Professor Strain, who also works as a hospital consultant. ‘This means tomorrow won’t be such a shock to them.’
Experts also say that resident doctors receive much more supervision than in the past.
‘When I started as a resident doctor, you were essentially let loose on the wards on Black Wednesday and expected to know what you were doing,’ says Dr Ron Daniels, an intensive care consultant and chief executive of the UK Sepsis Trust charity.
‘Today, there are experienced medics on hand to support the new resident doctors.’
However, Black Wednesday disruption should still be expected.
Experts say that the influx of new doctors will almost certainly slow down hospitals and, crucially, could lead to an increase to the number of patient admitted to wards.
‘New doctors are more likely to be risk-averse,’ says Professor Strain. ‘This means they might be more likely to order a blood test that is not necessarily needed or to keep patients in hospital for longer.
‘This isn’t a bad thing in itself, but it can mean that there is less space and resources for patients. And that’s particularly true at the moment due to the heat.’
Recent NHS data shows that A&E units were busier in June than in any winter month on record – largely due to heat-related sickness. Meanwhile 999 calls are up by 10 per cent compared to last summer.
Several hospitals have already been forced to cancel scans, blood tests and surgery due to the fact that NHS buildings and equipment are ‘not equipped to cope’ with the hot weather.
‘NHS hospitals have very little extra capacity at the moment,’ says Professor Strain.
‘If Black Wednesday causes the number of patients in hospital to go up and also increases the number of tests being carried out, then it’s possible that some hospitals might need to cancel routine procedures.’
For this reason, experts advise that anyone with minor injuries or illnesses should avoid A&E tomorrow – or expect to face long waits.
‘There are better and quicker ways to get treatment for these sorts of issues,’ Professor Strain adds.
Experts say that, in many cases, pharmacists can help with medical issues such as bladder infections, sore throats, shingles and possible infections – and can provide treatment much quicker than a hospital.
However, experts also stress that anyone with a serious issue – such as breathing difficulties, severe chest pain, sudden confusions, severe bleeding or fits and seizures – should still go straight to A&E.
And they add that the disruption caused by Black Wednesday is only temporary.
‘Resident doctors pick up a lot of experience and confidence very quickly,’ says Dr Daniels.