Working Hours Of Junior Doctors Research Articles

Reducing non-clinical working hours of junior doctors could benefit patient outcomes

Dear Editor, An 80-hour duty limit for residents was first introduced by the Accreditation Council for Graduate Medical Education (ACGME) in 2003, with the further addition of a 16-hour continuous duty period limit for first-year residents in 2011. Prior studies1 have demonstrated an association between longer working hours and increased risk of mental illness,2 attentional

'Hospital at Night' improves outcomes: does the evidence support opinions?

Address correspondence to Prof. F.P. Cappuccio, Clinical Sciences Research Institute, University of Warwick, Warwick Medical School, U.H.C.W. Campus, Clifford Bridge Road, Coventry CV2 2DX, UK. email: f.p.cappuccio@warwick.ac.uk The Modernization of the National Health Service (N.H.S.) and medical careers have brought over the last 10 years or more growing pressures and demands for radical changes in the way we deliver safe and effective healthcare and train new doctors to fit these changes. At the same time, there has been increasing awareness at a European level that both patients and doctors are exposed to health risks due to excessive working hours of junior doctors. A legislative framework to reduce average working hours to no more than 48 h/week was then introduced in Europe (with the view to be implemented fully on 1 August 2009), which has added to the challenges and has sparked a much heated debate.

The European Working Time Directive and training in cardiothoracic surgery in the United Kingdom: A report of the Specialty Advisory Board in Cardiothoracic Surgery of The Royal College of Surgeons of Edinburgh

The European Working Time Directive (EWTD) limited average working hours for junior doctors to 58 per week in 2004. The Cardiothoracic Specialty Advisory Board conducted postal and email surveys of cardiothoracic trainees' work patterns and attitudes in 2003 and 2005-6. The results reveal an increase in shift-based working from 15% to 58% of respondents. One hundred per cent of respondents felt that the EWTD had had a negative impact on training, and only 30% were satisfied with their training to date. Satisfied trainees were more likely to work in larger units as assessed by ITU beds (20.6 vs. 8.9, p < 0.001) and cardiac cases/year (1586.2 vs. 828.4, p < 0.001). They had performed more cardiac cases than their peers (72.7 vs. 26.7, p = 0.005). Fifty-two per cent thought that their quality of life improved after EWTD implementation. The EWTD is unpopular amongst cardiothoracic trainees, who perceive it as harming training. Overall trainee satisfaction is low. Larger units and increased personal operative experience are associated with trainee satisfaction. Training programmes must act vigorously to safeguard training quality before implementation of the 48-hour limit in 2009.

NHS Update Freeman Hospital: the will to survive

The future looks uncertain for the Freeman Hospital trust in Newcastle upon Tyne. There are plans to rationalise the health service in Newcastle by shifting resources from secondary to primary care, and by providing more services locally for people who live in the region but outside Newcastle. These could reduce the level of contracts that purchasers place with the trust in the future. Staff at the trust say the service they provide is good value for money, but purchasers do not seem to take this into account. Instead of choosing from a "shopping list" of priced procedures, purchasers are forcing the trust to dovetail its prices to meet their budgets. There is also concern at the potential impact on the trust's financial situation of reduced working hours for junior doctors and the Calman proposals on training.

Excessive working hours of junior doctors

Excessive working hours of junior doctors

Excessive working hours of junior doctors

Excessive working hours of junior doctors

Excessive working hours of junior doctors

Excessive working hours of junior doctors

Excessive working hours of junior doctors

Excessive working hours of junior doctors

Excessive working hours of junior doctors

Excessive working hours of junior doctors

Excessive working hours for junior doctors

Excessive working hours for junior doctors