{"id":873,"date":"2013-08-02T03:30:37","date_gmt":"2013-08-02T07:30:37","guid":{"rendered":"http:\/\/blogstemp2.wpengine.com\/?p=873"},"modified":"2013-08-02T03:30:37","modified_gmt":"2013-08-02T07:30:37","slug":"a-time-of-transition","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2013\/08\/a-time-of-transition\/","title":{"rendered":"A Time of Transition"},"content":{"rendered":"

\"August-2013-Calendar\"<\/a>August is here, and we are deep in the throes of a new academic year.\u00a0\u00a0With this annual cycle, we\u00a0deal with\u00a0transitions in the academic medical world \u2013 many of which seem somewhat painful at first glance but, on closer inspection,\u00a0 actually can be quite fun.\u00a0 Many of you in medical training undoubtedly have moved into\u00a0new roles: be it matriculation from student to intern, or adjusting to the care manager and team leader simultaneous roles with the switch from intern to resident.\u00a0 The transition from junior resident to senior resident typically is\u00a0less dramatic, but generally means more time for self-directed learning and a focus on the next steps in your career.\u00a0 Arguably, the most unnerving transition is that from senior resident to independent practitioner.\u00a0 That said, a great number of NEJM Journal Watch readers have likely opted to continue training and begin fellowship (the category to which I belong!).<\/p>\n

A few researchers have looked into whether this abrupt transition each academic year has an effect on patient care.\u00a0 Dubbed the \u201cJuly effect,\u201d studies have shown some evidence of decreased quality of healthcare in July (with careful attention to how quality is defined).\u00a0 A meta-analysis of such studies was published in the Annals of Internal Medicine <\/i>in 2011 (see the NEJM Journal Watch summary here<\/a>), which reported higher patient mortality, as well as lower hospital efficiency during this trainee transition period.\u00a0 However, the evidence is not strong, and further inspection with high-quality studies is needed.\u00a0 I would argue that, in fact, new trainees have an intense focus and are highly motivated to do an excellent job \u2013 particularly when starting at a new position.\u00a0 Combining this with attending physicians\u00a0who take\u00a0a more hands-on approach to guiding their trainees so early in their careers, I believe a strong argument can be made that patients receive better<\/i>, if not equal, care in July as in other months.\u00a0 Regardless, attentiveness to detail and a low threshold for seeking help when needed is prudent, particularly during these first few months.<\/p>\n

The new academic year has also brought my own transition to fellowship training; it has been an incredibly exciting progression (and sometimes scary!) to now call myself a cardiology fellow.\u00a0 This transition has provided me with new motivation to understand and master new skills, this time not only to increase my knowledge base with specific focus on cardiovascular medicine, but also to prepare for eventual independent practice as a cardiologist.\u00a0 The transition from chief resident to first-year fellow has been quite humbling at times, but I clearly remember the transition from medical student to intern just a few years ago\u00a0\u2013 it’s not significantly different!<\/p>\n

As you might have guessed, this new role for me also means the time has come to pass the baton of the Journal Watch Chief Resident Blog to a new pair of authors, to whom you\u2019ll be introduced shortly (stay tuned for a new post soon…).\u00a0 I wish each of you the best of luck in your new positions, whatever and wherever they may be!<\/p>\n

Kindest regards,<\/p>\n

Jonathan Schwartz, MD<\/p>\n","protected":false},"excerpt":{"rendered":"

August is here, and we are deep in the throes of a new academic year.\u00a0\u00a0With this annual cycle, we\u00a0deal with\u00a0transitions in the academic medical world \u2013 many of which seem somewhat painful at first glance but, on closer inspection,\u00a0 actually can be quite fun.\u00a0 Many of you in medical training undoubtedly have moved into\u00a0new roles: […]<\/p>\n","protected":false},"author":24,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2],"tags":[36,37,42],"class_list":["post-873","post","type-post","status-publish","format-standard","hentry","category-about-residency","tag-resident-blog","tag-resident-experience","tag-thanks"],"yoast_head":"\nA Time of Transition - Insights on Residency Training<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2013\/08\/a-time-of-transition\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"A Time of Transition\" \/>\n<meta property=\"og:description\" content=\"August is here, and we are deep in the throes of a new academic year.\u00a0\u00a0With this annual cycle, we\u00a0deal with\u00a0transitions in the academic medical world \u2013 many of which seem somewhat painful at first glance but, on closer inspection,\u00a0 actually can be quite fun.\u00a0 Many of you in medical training undoubtedly have moved into\u00a0new roles: […]\" \/>\n<meta property=\"og:url\" content=\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2013\/08\/a-time-of-transition\/\" \/>\n<meta property=\"og:site_name\" content=\"Insights on Residency Training\" \/>\n<meta property=\"article:published_time\" content=\"2013-08-02T07:30:37+00:00\" \/>\n<meta property=\"og:image\" content=\"http:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2013\/08\/August-2013-Calendar-300x225.jpg\" \/>\n<meta name=\"author\" content=\"Jonathan Schwartz\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Jonathan Schwartz\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"3 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2013\/08\/a-time-of-transition\/\",\"url\":\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2013\/08\/a-time-of-transition\/\",\"name\":\"A Time of Transition - Insights on Residency Training\",\"isPartOf\":{\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/#website\"},\"datePublished\":\"2013-08-02T07:30:37+00:00\",\"dateModified\":\"2013-08-02T07:30:37+00:00\",\"author\":{\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/#\/schema\/person\/1c25b04cdc71941bde083fbe88ebb86b\"},\"breadcrumb\":{\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2013\/08\/a-time-of-transition\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2013\/08\/a-time-of-transition\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2013\/08\/a-time-of-transition\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/blogs.nejm.org\/general-medicine\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"A Time of Transition\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/#website\",\"url\":\"https:\/\/blogs.nejm.org\/general-medicine\/\",\"name\":\"Insights on Residency Training\",\"description\":\"Observation of residents across diverse medical specialties\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/blogs.nejm.org\/general-medicine\/?s={search_term_string}\"},\"query-input\":\"required name=search_term_string\"}],\"inLanguage\":\"en-US\"},{\"@type\":\"Person\",\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/#\/schema\/person\/1c25b04cdc71941bde083fbe88ebb86b\",\"name\":\"Jonathan Schwartz\",\"description\":\"Jonathan is a native Minnesotan, raised in Rochester, who grew up surrounded by the medical community. 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