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Invited Commentary
March 2016

Debunking the July PhenomenonAre We Asking the Right Questions?

Author Affiliations
  • 1Center for Surgery and Health Economics, Department of Surgery, University of Pennsylvania, Philadelphia
JAMA Surg. 2016;151(3):224-225. doi:10.1001/jamasurg.2015.3947

Heightened concern for patient safety emerges each July with the influx of new medical trainees and the transition of current residents to new roles. Referred to as the July phenomenon, this time period, and the potential association with increased medical error, remains a highly debated topic in the field of medicine and in society. To date, studies show conflicting results; many question whether this phenomenon really exists. In 2006, Englesbe et al1 showed an increase in surgical morbidity and mortality during July and August using risk-adjusted National Surgical Quality Improvement Program data. Yet no difference during this time period was seen in a 2011 study by Elhert et al,2 who also used National Surgical Quality Improvement Program data to examine the 10 most common general surgery procedures. The existing literature in the fields of trauma,3 cardiac surgery,4 and obstetrics5 also refutes the existence of a July phenomenon.

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