“Freshman effect” on care for gynecologic surgery at a teaching hospital in Korea = “Freshman effect” on care for gynecologic surgery at a teaching hospital in Korea

다국어 초록 (Multilingual Abstract)

Objective: The freshman effect, so-called July phenomenon in United States, is a perceived increase in the risk of medical errors and surgical complications that occurs in association with the time of academic year in which medical school graduates begin residencies. The purpose of this study was to evaluate the presence of the freshman effect in patients who underwent gynecologic surgery at a teaching hospital in Korea by comparing surgical outcomes, morbidity, and mortality rates between the first academic quarter and other quarters.
Methods: All data were collected prospectively (ClinicalTrials.gov Identifier: NCT02405936) and the study was approved by the Institutional Review Board. Between January 2015 to March 2018, patients who underwent gynecologic surgery during the first academic quarter (March, April, or May in Korea) were retrospectively compared patients who underwent gynecologic surgery during the other academic quarters. The primary outcome measure was the incidence of operative complication. Secondary outcomes were the operative time and the operative blood loss.
Results: Among 1241 patients who underwent gynecologic surgery during the study period of 39 months, 1136 patients were analyzed and divided into the first academic quarter group (n=335) and the other academic quarters (n=801). The baseline characteristics were not different between two groups. When separately analyzed each phase of operative time, the skin closure time in the first academic quarter group significantly took 13.4% longer than that in the other academic quarters group (13.5 9.9 min versus 11.9 7.0 min; P = 0.009). No significant differences were in operative blood loss and length of hospital stay. No significant difference in operative complication was found in the first and other academic quarters groups (1.5% versus 3.0%; P =0.143).
Conclusion: This study does not demonstrate the presence of a freshman effect or an increase in morbidity or mortality at Korean teaching hospital providing gynecologic surgical care.