SDN members see fewer ads and full resolution images. Join our non-profit community!

The new interns are coming!

Discussion in 'General Residency Issues' started by sddoc, Apr 21, 2007.

  1. sddoc

    sddoc Senior Member 7+ Year Member

    277
    0
    Jan 6, 2003
    Rapid City, SD
    I can't help it... I'm a little excited to see next year's interns visiting our facility while they are in town looking for a place to live. This can only mean one thing - I am about to get a significant piece of my life back in July when these people show up and I become an upper level resident! Is it wrong to be so happy about someone else's impending suffering?

    BTW... I am about to get some of my life back, right?:scared:
     
  2. SDN Members don't see this ad. About the ads.
  3. Blue Dog

    Blue Dog Fides et ratio. Physician Gold Donor SDN Advisor Classifieds Approved 10+ Year Member

    10,882
    2,649
    Jan 21, 2006
  4. lucky_deadman

    lucky_deadman Working Class Hero 5+ Year Member

    388
    1
    Aug 6, 2006
    Southeast USA
    Hey, some of us, I reiterate some, are not wet behind the ears. I personally have been around the corner, thrown under the bus and ran over several times. I agree that there is much for all of us to learn, but I'll try to kill as few patients as possible during this process. :rolleyes:
     
  5. Blue Dog

    Blue Dog Fides et ratio. Physician Gold Donor SDN Advisor Classifieds Approved 10+ Year Member

    10,882
    2,649
    Jan 21, 2006
    Try to retain your sense of humor, too. ;)
     
  6. Tired

    Tired Fading away 7+ Year Member

    3,886
    770
    Dec 12, 2006
    So this will be your second internship then? :rolleyes:

    For what it's worth, a review of PubMed shows about half-a-dozen studies looking at the supposed "July phenomenon", and none validate increased morbidity/mortality.
     
  7. sddoc

    sddoc Senior Member 7+ Year Member

    277
    0
    Jan 6, 2003
    Rapid City, SD
    That's probably because nurses and attendings are on heightened alert through September. ;)
     
  8. mlw03

    mlw03 Senior Member Physician 10+ Year Member

    3,128
    125
    Aug 15, 2003
    Canada
    i'm all for evidence-based medicine, but i'd still be damn scared to go to a teaching hospital in july. however i also agree that the fact that there isn't an increased morbidity/mortality rate is because the higher-ups are on high alert for the first few months while the interns get their bearings.
     
  9. Tired

    Tired Fading away 7+ Year Member

    3,886
    770
    Dec 12, 2006
    Ah yes, that must be why all the attendings take in-house night call from July to September.

    Oh wait.
     
  10. lucky_deadman

    lucky_deadman Working Class Hero 5+ Year Member

    388
    1
    Aug 6, 2006
    Southeast USA
    Depends on your definition of internship. If you count the school of hard knocks then I'm about a PGY 12. :D
     
  11. lucky_deadman

    lucky_deadman Working Class Hero 5+ Year Member

    388
    1
    Aug 6, 2006
    Southeast USA
    What the sarcasm alert wasn't flashing on your screen like it was mine? :D
     
  12. Mumpu

    Mumpu Burninator, MD 5+ Year Member

    1,198
    2
    Aug 1, 2004
    Man, there better be some hot and single ones... :)

    I do look forward to a pretty hefty pay raise and not doing cross cover.
     
  13. AmoryBlaine

    AmoryBlaine the last tycoon 7+ Year Member

    2,180
    21
    May 1, 2006

    Ha ha ha ha ha ha.
     
  14. fab4fan

    fab4fan TiredRetiredRN Classifieds Approved 10+ Year Member

    2,399
    526
    Jun 29, 2002
    Desolation Row
    Just when you remember their names, they leave. ;)
     
  15. carrigallen

    carrigallen 16th centry dutch painter 10+ Year Member

    1,542
    7
    Feb 27, 2003
    Not in the NBER study:

    In Cohort Turnover and Productivity: The July Phenomenon in Teaching Hospitals (NBER Working Paper No. 11182), authors Robert Huckman and Jason Barro investigate a third form of turnover, the extreme, though not uncommon, scenario that they term cohort turnover.

    Using data on all patient admissions from a large, multi-state sample of American hospitals over a five-year period, the authors find that both minor and major teaching hospitals experience a significant increase in resource utilization -- measured by average length of stay (LOS) -- immediately following the July turnover, and that the effect appears to last for several months. They also find that teaching hospitals with medium teaching intensity experience a significant increase in patient mortality over the same period. The confluence of increased resource utilization and increased mortality (in other words, decreased quality) during the July-August period implies that this cohort turnover reduces medical productivity.

    Nevertheless, those hospitals with the highest teaching intensities (the greatest reliance on residents for the provision of care) seem to avoid the disruption of the July phenomenon with respect to average mortality rates. The authors' preliminary evidence suggests that higher supervision levels play a role in mitigating the impact of the July turnover in major teaching facilities.

    The magnitude of the estimated effects is substantial and appears to last for roughly six months. The average LOS for the average, major teaching hospital increases by roughly 2 percent following the July turnover and remains between 1 percent and 2 percent higher throughout the final six months of the calendar year. Similarly, the average, major teaching hospital experiences an increase in risk-adjusted mortality of roughly 4 percent in the July-August period. This effect also remains at levels between 2 percent and 4 percent for the last six months of the calendar year. For the average major teaching hospital, this translates into between 7.8 and 13.8 "accelerated" deaths (that is, deaths that occur earlier than they would have in the absence of the July turnover) per year. Based on a total of roughly 200 major teaching hospitals in the United States, the July phenomenon is thus associated with roughly 1,500 to 2,750 accelerated deaths per year in the United States. The authors do not estimate the social cost of this increase in mortality.
     
  16. PainDr

    PainDr 7+ Year Member

    470
    1
    Sep 13, 2003
    I suspect your experience via the "school of hard knocks" will help you survive the first few hours. After that, you're just "fresh meat"...like everyone else.:smuggrin:
     

Share This Page