Faculty Opinions recommendation of Medical errors involving trainees: a study of closed malpractice claims from 5 insurers.

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Abstract
This article reinforces my observations in an academic practice of anesthesiology that handoffs between residents and residents to attendings in both surgical and anesthesia practice represent a significant source of medical errors. The authors analyzed closed malpractice claims where trainees (87% residents) were judged to have played a significant role in the adverse outcome. They identified 240 claims (52% of which were general surgery or obstetrics and gynecology) where the role of the trainee was judged to be at least moderately important. Handoff problems were identified in 56 of these cases. The errors occurred between 1979 and 2001 which points out a weakness with closed claims studies, mainly that the data is quite dated before it becomes available. The findings are particularly relevant because the injuries occurred prior to the introduction of the Accreditation Council for Graduate Medical Education (ACGME) duty hours regulations in 2003. These regulations have dramatically increased the number of handoffs of care, especially from resident to resident. From my observation, the regulations have resulted in a better quality of life for the trainees and perhaps a reduced potential for patient injury due to resident fatigue. However this paper focuses attention on the real possibility that these regulations may have an adverse effect on patient safety because of the increased numbers of handoffs necessary to to comply with them.

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