As June turns to July and summer begins in earnest, hundreds of medical school graduates around the country begin their residencies. These residents typically practice medicine under the direct or indirect supervision of an attending physician.
These residencies are part of graduate medical training and a necessary step in producing competent health care providers.
It also means that, across the board, the medical providers treating you in July are more likely to be less experienced than those who may have treated you in June. Associated with this is a perceived increased risk of medical errors: the so called “July effect”. While that may sound relatively benign, in the United Kingdom it is called the “killing season.”
Studies have been done investigating whether there is in fact a July effect – whether medical errors increase during this month. The studies have been equivocal – some found no difference in the rates of complications, particularly when the study focused on a particular disease process such as appendicitis or acute cardiovascular conditions.
Other studies, including a 2010 study from the Journal of General Internal Medicine, found that medication errors increased 10% in July in teaching hospitals from 1979 to 2006. Interestingly, the study did not find a similar error increase in nearby non-teaching hospitals. This suggests an increase due to medical students beginning their residencies, and in particular the new responsibility of prescribing drugs independently.
One criticism of the study suggested that the supervision of residents has improved over time, so that this 10% number is skewed by earlier data.
In a situation where a new resident commits an error and causes harm – even death – to her patient, it’s important to examine the entire situation when coming to any conclusions about fault and responsibility. When teaching hospitals have to balance the need to teach its residents with the safety of its patients, it may be more likely that ultimate responsibility is on the system itself for failing to properly do so.
