Can doctor boot camp reverse the July effect?

Doctor boot camp

In medical circles, the July effect refers to the influx of new interns and residents into hospitals every year during this month. This period is allegedly characterized by an increase in medical errors and hospital deaths due to the nervousness and inexperience of new doctors (think Scrubs’ season one, episode one). Whether the July effect is a myth or not, there is no denying that interns often fail to hit the ground running and, while this is perfectly understandable, the medical profession is a field where there is little margin for error. Zero margin for error, to be specific.

In order to ease the transition from school to hospital for interns -and their patients too-, the Northwestern Memorial Hospital in Chicago and its Feinberg School of Medicine have developed a three-day doctor boot camp rife with intense practice on all manners of skills, including proper techniques for handling newborn babies, identifying surgical instruments, end-of-life care, do not resuscitate codes, and delivering bad news. The program was created in 2011 by the medical school's vice dean of education Dr. Diane Wayne, and it won an innovation award from the Association of American Medical Colleges the very next year. More than 90% of participants pass the first time, and those who don’t get a do-over until they succeed, a chance they will seldom if ever have when it comes to the real thing.

According to Wayne, the hospital has “great residents who come from all over the country, but we have no reliable way of knowing that these interns possess these skills.” Testing their skills -or lack thereof- may involve drawing fluid from the abdomen of a mannequin standing in for a patient with liver disease. However, the level of realism is taken up a notch or three during the end-of-life discussion sessions, where trained actors play the role of dying patients (think Seinfeld’s The Burning). In these role-play sessions, ethics expert Dr. Kathy Neely demonstrates how to empathetically talk and listen to patients, for instance counseling a single father with advanced cancer, worried about what will happen to his 12-year-old son.

Dr. Robert Englander of the Association of American Medical Colleges has praised the boot camp as part of a doctor-training trend in which hospitals focus more and more on patient safety. After all, being a doctor is more than just giving injections or changing bandages; having proper bedside manners and being able to establish a bond with patients as human beings is just as important as all the technical skills interns learn in medical school.

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