Association between ‘July phenomenon’ and emergency general surgery patient outcomes

Editor's Note

Emergency general surgery patients who were managed early in the academic year with an influx of new residents fared equally well, if not better, than patients who were managed later in the year in this study.

Compared to patients managed later, early patients had lower risk-adjusted odds of mortality, complications, and developing a secondary condition. Length of stay and hospital costs were comparable between early and late patients.

The analysis included nearly 1.5 million patients who had emergency general surgery between 2007 and 2011, weighted to represent more than 7 million patients from 581 US teaching hospitals.

The results suggest that concerns related to the “July phenomenon” are unfounded, the researchers concluded.

The influx of new surgical residents and interns at the beginning of the academic year is assumed to be associated with poor outcomes. Referred to as Importance the July phenomenon, this occurrence has been anecdotally associated with increases in the frequency of medical errors due to intern inexperience.