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Related Experiment Video

Updated: Oct 23, 2025

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The junior doctor changeover effect: does it exist in general surgery?

T E Baldock1, L R Brown2, R C McLean1

  • 1Health Education England North East, UK.

Annals of the Royal College of Surgeons of England
|August 25, 2021
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Summary

The junior doctor changeover in UK general surgery does not increase patient risk. This study found no significant difference in mortality or length of stay during these transition periods.

Keywords:
ChangeoverGeneral surgeryJunior doctorMortalityOutcomes

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Area of Science:

  • Medical Research
  • Surgical Outcomes
  • Healthcare Management

Background:

  • Junior doctor changeovers are traditionally viewed as high-risk periods for patient safety.
  • Limited contemporary evidence exists to support the perceived 'changeover effect' on patient outcomes.
  • This study aimed to investigate adverse patient events during junior doctor transition periods.

Purpose of the Study:

  • To evaluate the presence and impact of the 'changeover effect' on acute general surgical admissions.
  • To determine if junior doctor transition periods are associated with increased patient risk.

Main Methods:

  • Retrospective cohort study of over 61,000 acute general surgery patients in the North of England (2005-2016).
  • Inclusion criteria: patients aged 18+ admitted during 'changeover week' (first day + six days) and a comparator week four weeks prior.
  • Data analyzed included patient characteristics, diagnoses, comorbidities, procedures, mortality, and length of stay.

Main Results:

  • No significant difference in 30-day mortality (2.5% vs 2.6%) or length of stay (5.3 vs 5.2 days) between changeover and non-changeover groups.
  • Changeover week was not a predictor of increased mortality after multivariable adjustment (OR 1.06).
  • Analysis of initial junior and higher specialty trainee periods showed no significant outcome differences.

Conclusions:

  • This study provides contemporary evidence that the 'changeover effect' is not present in acute general surgical admissions.
  • Junior doctor transitions in this setting do not appear to adversely impact patient outcomes.
  • Findings suggest current systems effectively manage patient care during these transitional periods.