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Related Experiment Video

Updated: Jan 4, 2026

Utilizing a 3D Printed Laparoscopic Nissen Fundoplication Model to Shorten a Resident's Learning Curve
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Revisiting the "July Effect" in Plastic Surgery: New Data to Support Resident Autonomy.

Demetrius M Coombs1, Mustafa S Ascha2, Mona Ascha3

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Summary

The "July Effect" did not significantly increase postoperative complications in plastic surgery residency. Junior residents showed a slight increase in superficial surgical site infections during July-September, but overall risk remained minimal.

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Area of Science:

  • Medical research
  • Surgical outcomes
  • Plastic surgery training

Background:

  • The
  • July Effect
  • is a widely discussed phenomenon in medical residency programs.
  • This study specifically examined its impact on plastic surgery resident participation.
  • Investigating postoperative complications during the initial academic quarter (July-September) versus other periods.

Purpose of the Study:

  • To determine if the
  • July Effect
  • leads to increased postoperative complications in plastic surgery.
  • To analyze complication rates based on resident experience levels (junior vs. senior).
  • To assess operative times and complication frequencies during the first academic quarter.

Main Methods:

  • Utilized the American College of Surgeons National Surgical Quality Improvement Program database (2006-2010).
  • Analyzed complication rates for procedures involving junior (PGY1-PGY3) and senior (PGY4-PGY6) residents.
  • Employed propensity score matching and logistic regression for analysis, comparing Q3 outcomes with all other quarters.

Main Results:

  • No significant differences in overall complication rates or operative times were found between Q3 and other quarters for all procedures.
  • Superficial surgical site infections (SSI) approached significance in Q3 for all procedures (3.3% vs 2.5%).
  • Reconstructive procedures in Q3 showed a significant increase in SSI (3.5% vs 2.3%), but this was not significant when adjusting for resident PGY status.

Conclusions:

  • This study suggests the absence of a clinically significant
  • July Effect
  • in plastic surgery, indicating minimal risk with resident involvement.
  • Appropriate resident autonomy appears safe during both cosmetic and reconstructive procedures.
  • Highlights the need for a plastic surgery-specific database to overcome limitations of larger surgical databases.