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Rate of undesirable events at beginning of academic year: retrospective cohort study

BMJ 2009; 339 doi: (Published 14 October 2009) Cite this as: BMJ 2009;339:b3974

Rate of undesirable events due to Junior Staff may be underestimated

I applaud the paper by Haller et al which highlights the risks
associated with novice trainees in a large academic teaching hospital in
Australia. This paper is however highly specific for one speciality, in
this case anaesthetics.

From a hospital-wide perspective, risks associated with new junior
staff may be diluted as they are regularly changing units or wards. For
instance in our Paediatric Department we have junior staff (PGY2-PGY3)
regularly rotating to our wards. These junior doctors usually have had no
prior post-graduate paediatric experience, and have not been exposed to
our policies and procedures. This happens in all units in our hospital,
and most hospitals in Australia. If these rotations occur frequently, ie
every 3 months then the risks associated with new junior medical staff
will be diluted, although very much present.

It would be interesting to see if this study can be replicated more
widely. My suspicion is that we do not spend enough time training each
group of new junior staff who rotate through our units. This is primarily
due to time constraints.

Competing interests:
None declared

Competing interests: No competing interests

26 October 2009
Simon E Hauser
Clinical Services Director Women's & Children's Health
Northern Health, The Northern Hospital, 185 Cooper Street, Epping Vic 3076 Australia