‘Black Wednesday’ – First day of work for junior doctors


Thousands of junior doctors will start their new jobs on the day referred to as ‘Black Wednesday’ because of the higher patient death rate which occurs on this day.

Studies have linked the first Wednesday in August, the day newly qualified doctors start work in hospitals, to an increase in hospital deaths. This is also the time when training schedules change for junior medics who have already been working in hospitals.

According to reports, mortality rates increase by about 6% during this time.

A poll of junior doctors already working in hospitals indicates that they feel they do not have enough time to offer patients adequate care. Of the 1000 training medics who were polled by the Medical Protection Society, around 70% felt this way. Half of them said they had concerns about the quality of care at their workplace. Around 82% struggled with the long hours and 67% had difficulty dealing with the heavy workload. One in 20 juniors said they had been forced to take time off due to stress.

Medical experts said that the ‘black Wednesday’ phenomenon could be prevented by staggering the training rotations of junior doctors. The Academy of Medical Royal Colleges recommended that while the first year of the programme should start on the first Wednesday in August, junior doctors already working in hospitals should only change departments during September.

They stated that this will allow the newest doctors time to work with trainees who have already been in the job for a few months. An Academy spokeswoman said this, along with an existing scheme where new doctors shadow senior colleagues during their first few days, should aid in addressing the problem.

Shadowing for junior doctors was announced by the Department of Health during 2012 to allow support for graduates during their transition from university to doctors.

A spokeswoman from Health Education England said patient safety is the most important factor and they welcome the fact that shadowing has been implemented for all trainees.

A medico-legal adviser at the Medical Protection Society, Dr Pallavi Bradshaw, said that junior doctors struggling to cope with the long hours is not a new problem, but the fact that 70% felt that a lack of time affected the care they gave patients was of grave concern. He said this highlights the requirement for junior doctors to get support from senior clinicians and management during this crucial time in their careers.

Dr Andrew Collier, the co-chair of the British Medical Association’s Junior Doctors Committee, said the implementation of a shadowing scheme means new doctors are more prepared on their first day as they are familiar with the systems used in the hospital. This allows them to offer the patients the best possible care and leaves them feeling more confident.

He said that new doctors will still have to face the reality of heavy workloads and long hours which could leave them exhausted and potentially compromising patient care. However, despite shadowing, trusts need to do more to make the doctors feel that they are a valued part of the team.

The BMA is currently discussing new junior doctor contracts with NHS Employers which will help address the problems surrounding training, changeover and workload pressures.

Image Credit: Lydia


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Emma Brown

Emma graduated in 2005 from the University of York with a degree in English Literature. A huge passion for writing and health topics, Emma is a perfect match for Health News UK. Hobbies include; cooking, writing (of course), musicals and her 2 dogs.

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