This is the period, usually in August, when the influx of newly qualified doctors into the National Health Service (NHS) is associated with an increase in medical errors. The phenomenon has been recognised by Professor Sir Bruce Keogh, medical director of the NHS. The phenomenon is referred to in the United States as the “July effect”.
The term “killing season” originated in the 1994 British medical drama series Cardiac Arrest written by Jed Mercurio (under the pseudonym John MacUre). In an episode first broadcast on BBC1 on 5 May 1994, the character Dr. Claire Maitland consoles a junior who has just committed a fatal error with the dialogue: “You come out of medical school knowing bugger all. No wonder August is the killing season. We all kill a few patients while we’re learning.”
The day when junior doctors typically start work has been dubbed “Black Wednesday” among NHS staff. A 2009 Imperial College London study of records for 300,000 patients at 170 hospitals between 2000 and 2008 found that death rates were 6 percent higher on Black Wednesday than the previous Wednesday. The study also found that typically fewer patients attended A&E on the first Wednesday in August than the previous week.
