Skip to main content

Residency/Fellowship Training and the Complication

  • Chapter
  • First Online:
Cerebrovascular and Endovascular Neurosurgery

Abstract

Medical errors are believed to be the third leading cause of death in the United States and can have profound socioeconomic implications within the healthcare system. The need for academic teaching hospitals to effectively train resident physicians while minimizing the incidence of medical errors and ensuing complications during patient care has proven a significant challenge. National political efforts over the past two decades have introduced several interventions which aim to reduce the incidence of medical errors at these academic medical institutions. The precise relationship between the frequencies of complications associated with resident error, however, has been poorly elucidated in the past. Here, we provide a review of the current data on the relationship between medical care administered by residents and the incidence of complications. We further examine the role of fatigue, burnout, and duty hour restrictions on complication rates and consider the legal ramifications of resident error.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Borenstein SH, Choi M, Gerstle JT, Langer JC. Errors and adverse outcomes on a surgical service: what is the role of residents? J Surg Res. 2004;122(2):162–6. https://doi.org/10.1016/j.jss.2004.05.014.

    Article  PubMed  Google Scholar 

  2. Morgan MK, Assaad NN, Davidson AS. How does the participation of a resident surgeon in procedures for small intracranial aneurysms impact patient outcome? J Neurosurg. 2007;106(6):961–4. https://doi.org/10.3171/jns.2007.106.6.961.

    Article  PubMed  Google Scholar 

  3. Bydon M, Abt NB, De la Garza-Ramos R, Macki M, Witham TF, Gokaslan ZL, et al. Impact of resident participation on morbidity and mortality in neurosurgical procedures: an analysis of 16,098 patients. J Neurosurg. 2015;122(4):955–61. https://doi.org/10.3171/2014.11.JNS14890.

    Article  PubMed  Google Scholar 

  4. Prins JT, Gazendam-Donofrio SM, Tubben BJ, van der Heijden FM, van de Wiel HB, Hoekstra-Weebers JE. Burnout in medical residents: a review. Med Educ. 2007;41(8):788–800. https://doi.org/10.1111/j.1365-2923.2007.02797.x.

    Article  PubMed  Google Scholar 

  5. Prins JT, van der Heijden FM, Hoekstra-Weebers JE, Bakker AB, van de Wiel HB, Jacobs B, Gazendam-Donofrio SM. Burnout, engagement and resident physicians’ self-reported errors. Psychol Health Med. 2009;14(6):654–66. https://doi.org/10.1080/13548500903311554.

    Article  PubMed  CAS  Google Scholar 

  6. Demerouti E, Bakker AB, Nachreiner F, Schaufeli WB. The job demands-resources model of burnout. J Appl Psychol. 2001;86(3):499–512.

    Article  CAS  PubMed  Google Scholar 

  7. Shanafelt TD, Bradley KA, Wipf JE, Back AL. Burnout and self-reported patient care in an internal medicine residency program. Ann Intern Med. 2002;136(5):358–67.

    Article  PubMed  Google Scholar 

  8. Friedman RC, Bigger JT, Kornfeld DS. The intern and sleep loss. N Engl J Med. 1971;285(4):201–3. https://doi.org/10.1056/NEJM197107222850405.

    Article  PubMed  CAS  Google Scholar 

  9. Grantcharov TP, Bardram L, Funch-Jensen P, Rosenberg J. Laparoscopic performance after one night on call in a surgical department: prospective study. BMJ. 2001;323(7323):1222–3.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Ganju A, Kahol K, Lee P, Simonian N, Quinn SJ, Ferrara JJ, Batjer HH. The effect of call on neurosurgery residents’ skills: implications for policy regarding resident call periods. J Neurosurg. 2012;116(3):478–82. https://doi.org/10.3171/2011.9.JNS101406.

    Article  PubMed  Google Scholar 

  11. Hutter MM, Kellogg KC, Ferguson CM, Abbott WM, Warshaw AL. The impact of the 80-hour resident workweek on surgical residents and attending surgeons. Ann Surg. 2006;243(6):864–871; discussion 871–5. doi:https://doi.org/10.1097/01.sla.0000220042.48310.66.

  12. Landrigan CP, Rothschild JM, Cronin JW, Kaushal R, Burdick E, Katz JT, et al. Effect of reducing interns’ work hours on serious medical errors in intensive care units. N Engl J Med. 2004;351(18):1838–48. https://doi.org/10.1056/NEJMoa041406.

    Article  PubMed  CAS  Google Scholar 

  13. Gopal R, Glasheen JJ, Miyoshi TJ, Prochazka AV. Burnout and internal medicine resident work-hour restrictions. Arch Intern Med. 2005;165(22):2595–600. https://doi.org/10.1001/archinte.165.22.2595.

    Article  PubMed  Google Scholar 

  14. Dumont TM, Rughani AI, Penar PL, Horgan MA, Tranmer BI, Jewell RP. Increased rate of complications on a neurologicalsurgery service after implementation of the Accreditation Council for Graduate Medical Education work-hour restriction: clinical article. J Neurosurg. 2012;116:483–86.

    Google Scholar 

  15. Kachalia A, Studdert DM. Professional liability issues in graduate medical education. JAMA. 2004;292(9):1051–6. https://doi.org/10.1001/jama.292.9.1051.

    Article  PubMed  CAS  Google Scholar 

  16. Bailey RA. Resident liability in medical malpractice. Ann Emerg Med. 2013;61(1):114–7. https://doi.org/10.1016/j.annemergmed.2012.04.024.

    Article  PubMed  Google Scholar 

  17. Wegman B, Stannard JP, Bal BS. Medical liability of the physician in training. Clin Orthop Relat Res. 2012;470(5):1379–85. https://doi.org/10.1007/s11999-012-2244-4.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Crisman, C., Gupta, R., Majmundar, N., Gandhi, C.D. (2018). Residency/Fellowship Training and the Complication. In: Gandhi, C., Prestigiacomo, C. (eds) Cerebrovascular and Endovascular Neurosurgery. Springer, Cham. https://doi.org/10.1007/978-3-319-65206-1_3

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-65206-1_3

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-65204-7

  • Online ISBN: 978-3-319-65206-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics