Is there any Truth to the “July Effect?”


A July Spike in Fatal Medication Errors: A Possible Effect of New Medical Residents



Each July thousands begin medical residencies and acquire increased responsibilities for patient care. Many have suggested that these new medical residents may produce errors and worsen patient outcomes-the so-called “July Effect.” however, we have found no U.S. evidence documenting this effect.


We examined all U.S. death certificates, 1979-2006 (n=62,338,584), focusing on medication errors (n=244,388). We compared the observed number of deaths in July with the number expected, determined by least-squares regression techniques. We compared the July Effect inside versus outside medical institutions. We also compared the July Effect in counties with versus without teaching hospitals.


Inside medical institutions, in counties containing teaching hospitals, fatal medication errors spiked 10% in July and in no other month. In contrast, there was no July spike in counties without teaching hospitals. The greater the concentration of teaching hospitals in a region, the greater the July Spike. These findings held only for mediation errors, not for other causes of death.


We found a significant July spike in fatal mediations errors inside medical institutions. After assessing competing explanations, we concluded that the July mortality spike results at least partly from changes associated with the arrival of new medical residents.


J Gen Intern Med. 2010 Aug; 25(8): 774-779

It’s always been a joke among nurses and hospital workers to not get sick during the summer. With the amount of medications that patients are taking today it isn’t hard to fall victim of medication errors. Polypharmacy is the use of four or more medications by a patient, generally adults aged over 65 years. Polypharmacy is most common in the elderly, affecting about 40% of older adults living in their own homes. Bottom line is stay ahead of your health versus getting behind on it and make sure doctors who are treating you are aware of the medications you are taking where ever you go.

Dr. J

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