“July Effect” in Teaching Hospitals
Starting a new job always comes with a period of trial and error, uncertainty and learning as you go. But what if the new job is in a hospital treating patients? According to recent studies, medical residents are no different. More than 16,000 medical students receive their medical degrees (MD, OD) each year and many of them begin their residencies in the month of July. And this influx of green medical professionals in hospitals has some researchers believing in the "July Effect", an increase in mortality rates at teaching hospitals during the month of July.
A medical residency is a stage of graduate medical training that follows classroom education. It is an opportunity for physicians to learn practical skills and apply the knowledge they learned during medical school to actual patients. Residents have the choice to participate in residencies that specialize in plastic surgery, orthopedic, urology, radiology and other medical subsets. These residencies are generally conducted in a teaching hospital and all residents should be supervised by licensed physicians.
A research program conducted by the University of California, San Diego examined the "July Effect" by carefully studying the death certificates of over 240,000 former hospital patients that died in July between the years of 1979-2006. They found a surprising spike, around 10%, in the number of deaths related to medication errors in counties where teaching hospitals are located. This "July Effect" could be attributed to numerous factors. Medical residents are under considerable pressure to perform well and to prove themselves. Many are not willing to hurt their reputation by admitting they do not know something or have made a mistake. Many are acting on their new acquired semi independent roles. While this study has some people scared, hospital officials across the country are not convinced. They adamantly state that teaching hospitals have a strong system of checks and balances in place to prevent such terrible oversights or mishaps from occurring. They believe that the proper supervision they provide dramatically lessens the chance of errors.
Medical residencies have been the source of controversy for years. Often underpaid and over worked, residents have a history of working 100 plus hours a week, becoming sleep deprived and eventually making fatal or near fatal mistakes. Only recently have residents been restricted to 80 hour work weeks and only one overnight shift every three days. Still, the amount of work far exceeds that of normal professionals.
Until more research is conducted and more evidence can be produced, the best way to combat any possibility of succumbing to the "July Effect" is to simply be engaged and knowledgeable about the treatment one receives at any hospital or medical facility.
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