Opinion: Are med school grads prepared to practice medicine?

Each July at teaching hospitals across the country the most seasoned residents leave to begin independent practice, younger residents behind them move up a rank, and freshly minted M.D.s take their place as interns at the bottom of the ladder. The transition can be perilous: patient outcomes can suffer, and young doctors can be particularly vulnerable to burnout. Observers have long attributed the notorious "July effect" to the rookies who have stepped up to the plate, but in the wake of major reforms in the way doctors and residency programs are accredited, medical educators have begun believing that there's another reason.