Christoph NiemannTHE FACTS
Does an influx of medical trainees mean a spike in medical mistakes?
Every July, a new class of medical school graduates begins residency programs at teaching hospitals, giving rise to a popular belief that this month is a bad time to go in for treatment. Researchers call it the “July effect,” referring to the idea that mishaps and mortality rates rise when a fresh group of residents arrives at a hospital.
Though numerous studies have produced varying findings, a majority have found little evidence of such an effect. In a study published in Annals of Surgery, University of Michigan researchers examined mortality rates among 320,000 surgical patients over three years. They found no “significant monthly or seasonal variation in operative mortality rates.”
Another study, by researchers at the University of Minnesota, compared outcomes among heart patients from July to September with outcomes from October to June. The analysis found no significant difference in the medical management of patients in the two periods, and the authors disputed the idea of a “July phenomenon.”
But some researchers say looking at surgical residents and outcomes for severely ill patients obscures the effect, since surgical residents are often part of a team and patients with the most serious conditions receive more attention. The problem may be more apparent with regard to medical residents and their prescribing practices.
Last year in The Journal of General Internal Medicine, for example, a large study of teaching hospitals over several decades found that fatal medication errors spiked by 10 percent in July. The more such hospitals in a region, the authors concluded, the greater the spike in fatal errors. Some critics, however, noted that much of the data was collected decades ago, when residents were less closely supervised.
THE BOTTOM LINE
Though the debate continues, most studies have not found a spike in hospital mortality rates in July.