The July Phenomenon Revisited: New Insights on a Lore of Academic Medicine
Each July, teaching hospitals experience an influx of new residents and fellows who have recently graduated from medical school or completed residency training programs. During this period, teaching hospitals also assign new positions of responsibility to existing residents and fellows. Medical education is a core mission of teaching hospitals, and in these hospitals, interns, residents, and fellows play major roles in patient care. This recurrent cycle in which care is delivered by less experienced physicians in the initial month of the academic year has led to the often expressed conventional wisdom of "not to get sick in July."1
In addition to the lore surrounding July admissions to teaching hospitals, prior studies have shown that physician experience is an important determinant of outcomes for a wide range of medical conditions and procedures. 2-5 Moreover, literature from economics and other fields has shown that employee turnover can adversely affect organizational productivity.6,7 Given that teaching hospitals face both inexperienced physicians as well as high turnover early in the academic year, it is reasonable to be concerned about the potential for lower quality care around that time.
- Received October 20, 2013.
- Accepted October 21, 2013.