On-call Commitments Research Articles

Emergency Airway Management

Emergency Airway Management

Becoming a foundation year 1 doctor in August 2008?

It’s a cliche but also very true: the year ahead will be a huge rollercoaster of emotions and experiences. You may begin to doubt this if you’ve been left with unbanded jobs and few on-calls but it will still be one heck of an experience. No other occupation involves the highs and lows and the number of times a serious career change is considered as a career in medicine. That is even after just one year. Having emerged from an unbanded, though fairly busy 9-5-ish medical house officer job, I moved through a very busy surgical rotation with on-call commitments and am currently doing an interesting yet laid back psychiatry post. The first few weeks of every job are the hardest. While trying to get your head around different policies, the mind numbing rotas, and trying to ensure you get paid, thoughts often fill your mind—“Will my team like me?” “Will the nursing staff make my life a misery?” “Will I look like a fool …

Medical specialists’ allocation of working time

The aim of this study is to map the time-allocation of medical specialists and to examine how it relates to internal organising of work, wage incentives, physicians’ preferences and the demand structure in the population. With regards to internal organising of work and wage incentives, special attention is granted to the private–public divide in specialised healthcare. Survey data from 1183 Norwegian physicians is employed and the empirical models are estimated by means of ordinary least squares (OLS) regression analysis, linear logit analysis, binomial logistic regression analysis and multilevel analysis. Physicians working in the private sector and physicians combining private and public work spend relatively more time on patient-assignments than their public counterparts, while public physicians allocate more time to administrative and research/educational tasks. These findings support the proposition that work time allocations mirror the differences in on-call commitments, wage incentives and the division of labour between the sectors. Furthermore, whereas the demand-specific set of variables in the model contributes moderately to the explanation of working time allocation, internal organising of work and physicians’ preferences exert significant effects across the sectors. Future research should focus on physicians’ time allocation since the topic will remain relevant as the European Union's (EU's) Working Time Directive continues to shake the European healthcare systems with traditions for long workdays.

A preliminary study to evaluate the impact of problem-based learning (PBL) to a postgraduate clinical pharmacy programme in the UK

Background: The expanding volume of information on drugs and their application requires pharmacy educators to undertake a paradigm shift from teaching knowledge to teaching problem-solving skills. Aim: This study compares the use of problem-based learning (PBL) to traditional tutorial sessions in an MSc in Clinical Pharmacy Programme. Evaluation considers both assessment of knowledge and understanding and student perception to the learning experience. Method: Seventeen students were recruited to a randomised crossover trial conducted in two therapeutic modules. Results: No significant difference was found for assessment scores. In relation to attitude, students favoured PBL. Non-attendance was an issue, as students, engaged in full time employment and additional on-call commitments, were not mandated to attend. The authors conclude that the adoption of PBL does not harm traditional educational outcomes and is preferred by students. This work provides a baseline for further studies and will assist in the introduction of PBL to the postgraduate pharmacy curriculum.

Training in clinical oncology⇓

It can be emotionally draining, but it has sociable on-call commitments, structured training, and huge potential for doing research. Lye Mun Tho, Carrie Featherstone, and Nicholas Reed offer a guide to training in clinical oncology

What do hospital consultants value about their jobs? A discrete choice experiment

Objective To examine the strength of hospital consultants' preferences for various aspects of their work.Design Questionnaire survey including a discrete choice experiment.Setting NHS Scotland.Participants 2923 hospital consultants in Scotland.Main outcome...

Courtesy towards NHS staff is a must

I had just started as a new medical house officer in an eminent teaching hospital on the south coast of England, having recently completed my surgical job. Like all new doctors, I spent the first few days finding my way around the wards and getting to know the routine. I was booming with enthusiasm and confidence and was somewhat arrogant. The job certainly was not easy. A typical day consisted of an endless ward round, and during on-calls we would be lucky to have a few minutes to ourselves. On a typical post-take ward round we saw more than 20 new admissions, and, with an on-call commitment of one in four, we were always on the go. I was initially taken aback by the enormity of the workload in …

The neuroanaesthesia workforce in Great Britain and Ireland.

A survey of the 36 units that provide a neuroanaesthesia service in Great Britain and Ireland was conducted. It shows the variation in the type of hospital, the number of whole-time equivalent neuroanaesthetists, the number of operating sessions and the number of neurosurgical beds per million of the catchment population of each unit. On-call commitment and arrangements for managing long cases are described. Current problems pertaining to neuroanaesthetic practice are mentioned. This survey will provide a basis for the planning of future neuroanaesthetic services, as the potential of expansion of neurosurgery and neuroradiology is realised. However, it is difficult to make accurate projections and hence advise on future workforce requirements in a climate of changing service delivery. Attention should be given to a number of workforce issues highlighted in this survey if recruitment into neuroanaesthesia is to be encouraged.

Factors that inform the career choice of medical students: implications for otolaryngology.

Knowledge of the factors that inform the career choice of medical students may help plan the workforce for medical specialties. To determine which factors inform the career choice of medical students we carried out a survey of medical students at the start of their educational block in Otolaryngology. Of 202 questionnaires handed out 169 were returned (84 per cent). Students were asked to rank factors according to their importance in their career choice. The single most important factor was career progression. Other factors include on-call commitment, teachers as role models, and the interest for a particular subject. At the present time progression from senior house officer grade to specialist registrar grade in Otolaryngology is delayed. If this issue is not addressed the influx of applicants into Otolaryngology training programmes will be reduced, limiting the pool from which candidates can be chosen for a career in Otolaryngology.

Attitudes of surgical trainees towards transplantation surgery as a career.

At present there are a number of unfilled consultant posts in transplantation surgery in the United Kingdom, particularly within the field of kidney transplantation. Unless the current shortfall is addressed, it seems highly probable that the number of unfilled consultant posts will continue to increase. This survey aimed to highlight the reasons underlying trainees' reluctance to enter the field of transplantation surgery and to assess how the specialty might be changed to attract new trainees. Questionnaires were sent to 102 surgical trainees requesting details on age, sex, training grade, research interests and chosen specialty. They were asked to consider nine specified reasons commonly thought to influence a trainee's decision on whether or not he/she would enter their chosen specialty and to grade each of these according to their relative importance in the context of considering a career in transplantation. The survey then suggested five changes in training/structure, and the trainees were again asked to grade the relative importance of each with regard to whether it would attract them towards transplantation surgery. Replies were received from 61 trainees (60%). Trainees were deterred from transplantation surgery because of the on-call commitment, unpredictable workload, lack of exposure and a lack of information on the specialty. A reduced on-call commitment, increased income, increased exposure, improved training structure and increased information would all serve to attract new trainees to the specialty. To attract new trainees to transplantation surgery, there must be exposure to the specialty at an earlier stage in training, and a proactive stance must be adopted in providing information for the trainees. In addition, there needs to be ongoing commitment to improvements in training structure. The issues of increased income and an acceptable on-call commitment must be addressed.

The clinical load of HIV and AIDS for genitourinary physicians.

We aimed to investigate the extent of genitourinary medicine (GUM) involvement in the clinical management of HIV. A questionnaire survey was conducted on GUM consultants in the UK and the Irish Republic. Clinics were divided into teaching hospitals (THs) undertaking both undergraduate and postgraduate training in GUM, non-teaching training (NTT) centres undertaking specialist training only and non-teaching (NT) centres. Information was obtained on 241 of the 250 consultants on the Royal College of Physician's GUM Committee's records from 117 GUM clinics (including all THs and NTT centres). Four (1 TH and 2 NTT centres) GUM clinics did not see HIV-positive patients, 62 saw 10-99 patients, 18 reported 100-999 and 4 with over 1000 patients attending in 1996. Thirty-five per cent of the 55 THs and NTT centres had over 100 HIV patients. Consultants were involved in the outpatient care of HIV patients in 99.5% and GUM trainees in 85.5% clinics. Overall 47 clinics have their own inpatient HIV beds and 176 consultants (73%) had full (100) or significant (76) input to inpatient HIV management. Only 29% of THs and 12.5% of NTT centres had none or minor input into HIV care. HIV inpatient on-call commitment by the GUM trainees was reported by 64% of training centres. GUM services provide a major input into outpatient and inpatient care of HIV-infected patients in the UK.