Skip to main content
Skip to navigation

This site is archival. Please visit the current MIZZOU magazine site for up-to-date content.

Around the Columns

Medical student researches surgeries during summers

Douglas Overbey

Douglas Overbey found that cardiothoracic patient care isn’t sacrificed during new residents’ first months on the job. He presented his research at the Academic Surgical Congress in Huntington Beach, Calif., in February 2011. Photo by Nicholas Benner

Douglas Overbey hasn’t yet performed his first surgery; he’s only a third-year medical student. But he already expects that his first few patients will be nervous. During his surgery rotation, he often heard patients remark to new residents: “What year are you?” or “Gee, you look young.”

For about six months, Overbey of Cape Girardeau, Mo., looked into this so-called July Effect, which assumes that patient care is poorer during beginning residents’ first few months. July is the transition month in teaching hospitals as new residents begin postgraduate training. Overbey’s research, however, concludes that patients undergoing coronary artery bypass surgery in July, August or September have better outcomes in teaching hospitals than in nonteaching hospitals.

The July Effect has been studied for more than 20 years with varied results. With help from the MU Division of Cardiothoracic Surgery, Overbey focused on coronary artery bypass grafting (CABG), a common but intricate surgery. Using a national database of 1 million CABG operations, he looked for discrepancies between the first academic quarter (July to September) and the last (April to June).

Although teaching hospitals recorded slightly more postoperative complications than nonteaching hospitals during the first quarter, their mortality rates were lower. The July transition also only led to a 2.4 percent increase in failure to rescue, or deaths after complications, in teaching hospitals. In nonteaching hospitals, rates jumped 19.1 percent during this time period.

Overbey says teaching hospitals likely performed better from July to September because of heightened awareness.

“At first, new residents are slightly less sure of themselves, so they review their work and take more precautions to ensure patient care is not sacrificed,” says Overbey, who was recognized with the Dean’s Award for Outstanding Student Research. “At a teaching hospital, there are also several levels of people in training looking over the patient. The extra care seems to lead to better outcomes.”

Click here to download a poster showing Overbey's research results.