What Is the 'July Effect'

The July effect, also known as the ‘July phenomenon’, describes the belief that there is an increase in medical errors and complications in hospitals around July – stemming from the fact that this is when most medical school graduate begin their residency. But is this just undue panic, or could these new graduates really have a negative impact on the quality of health care?

Studies on the July Effect

This somewhat concerning belief has been looked at in various studies, and in one review in the Journal of General Internal Medicine (2010) it was found that medical errors did indeed increase by 10% in July based on records spanning from 1979 to 2006 – but only in teaching hospitals and not in the other hospitals in the area. Surgical complications did not increase meanwhile, presumably due to the stricter cross checks and examinations. The study could not prove a causal link however between the influx of new residents and the increase in problems. It’s also possible that the results of the study were skewed by the inclusion of old data when recent developments should have improved rates.

Many other studies have found varying results – a large number of studies looked at patients with particular illnesses and failed to find an increased chance of medical errors for those with medical traumas, appendicitis, cardiovascular conditions etc. However, small increases were found in other studies looking at general surgical outcomes and cerebrospinal fluid shunt surgery.

What to Make of the Findings

While these studies don’t definitively prove a link between an influx of new graduates and an increase in medical errors, they certainly might be enough to set off alarm bells for some patients. But should you really read anything into these findings?

Well obviously the most important thing to bear in mind is that you can’t choose when you get ill – if you have a problem you are concerned with you should get medical help regardless of what month it is. Meanwhile if you need immediate medical help then you should go to the nearest hospital and not be too hung up on whether or not it’s a teaching hospital. There is a chance of error no matter where you go. Apart from anything else not every recent student is going to be immediately completely competent come the end of July – so there’s no point worrying about things outside of your control. An opposite argument could of course be made that someone fresh from graduating would be more likely to remember what they learned and more likely to take the very most care in everything they do.

However if you are the nervous type and you are concerned about the July effect, and if you have the choice of local hospitals, then you may of course want to put your mind at rest by opting against teaching hospitals. That is your prerogative and if it helps you to relax then it’s worthwhile.

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