Abstract
Surgical training has undergone considerable reforms in order to emphasise a structured training programme with supervision in a framework of clinical governance. This was following Sir Kenneth Calman's proposed reforms of the registrar grades in 1993. The European Working Time Regulations (EWTR) became part of British law in 1998 and since August 2009 also includes junior doctors, limiting maximum working times to 48 hours per week with specific rest requirements. This has raised concerns from organisations, such as the British Medical Association and the Royal College of Surgeons, regarding the effect on training and whether changes are needed to prevent a loss in competency and confidence. The 2010 report by Professor Sir John Temple found a lack of conclusive data on the effects of the EWTR on training. However, it recommended that fundamental changes must be made to the way training and service are delivered.
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