New Medical Residents and Patient Mortality – Does the ‘Nurse Effect’ Lessen the ‘July Effect’?

Last week, a post on the New York Times Well blog discussed whether mortality rates in hospitals are worse during July when new interns and residents begin their clinical training. It described findings from three studies, with the final conclusion, “Though the debate continues, most studies have not found a spike in hospital mortality rates in July.”

It was common thinking in hospitals when I worked clinically—“Never be sick enough to have to go to a hospital the first two weeks of July, and NEVER, EVER need surgery during that time”—and I’d venture that many people still believe it, despite what studies may report. (And, as I write, I see that ABC News is reporting on a new review of 39 studies, published in the Annals of Internal Medicine, that does support the existence of the July Effect. Click the image below for the ABC article and videos.)

I remember working in the ED when the new residents on call would come to see patients, their “whites” impeccably spotless and starched, with new blank index cards in their pockets, looking eager and anxious to finally be getting to the real work of their profession. By mid-August, they all seemed a bit haggard, the whites rumpled and the pockets torn a bit, bulging […]