Trainee inexperience is associated with longer procedure times but no increase in complications for cardiac device implantation

Background The “July phenomenon” describes poor patient outcomes in teaching hospitals at the beginning of a new academic year when trainees begin. Whether this phenomenon truly exists is unclear. Objective The purpose of this study was to identify whether trainee and attending inexperience is associated with cardiac electrophysiologic procedural outcomes including total procedure time, fluoroscopy time, and complications. Methods We retrospectively reviewed the available electronic records of 488 consecutive patients undergoing initial dual-chamber pacemaker (PM) or cardiac resynchronization therapy (CRT) device implantation performed at University of California, San Francisco from February 2004 through November 2011. We calculated physician’s year of experience using the procedure date and the physician’s job start date. Patients were stratified into two subgroups based on their device type. Procedural outcomes including procedure length, fluoroscopy time, and complications were retrieved from electronic databases. Results After multivariate analysis, fellow experience was associated with decreased procedure time (19% less procedure time/year of experience, 95% confidence interval [CI] 13%–25%, P