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The new interns are coming!

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

  1. sddoc

    sddoc Senior Member
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    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:
     
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  3. Blue Dog

    Blue Dog Fides et ratio.
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  4. lucky_deadman

    lucky_deadman Working Class Hero
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    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.
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    Try to retain your sense of humor, too. ;)
     
  6. Tired

    Tired Fading away
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    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
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    That's probably because nurses and attendings are on heightened alert through September. ;)
     
  8. mlw03

    mlw03 Senior Member
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    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
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    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
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    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
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    What the sarcasm alert wasn't flashing on your screen like it was mine? :D
     
  12. Mumpu

    Mumpu Burninator, MD
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    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
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    Ha ha ha ha ha ha.
     
  14. fab4fan

    fab4fan TiredRetiredRN
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    Just when you remember their names, they leave. ;)
     
  15. carrigallen

    carrigallen 16th centry dutch painter
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    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

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    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:
     

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