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“Current surgical trainees will be less skilled”

The majority of surgical trainees are unhappy with the quality of their training, a study has revealed.

Seven in ten of the 310 trainees of all grades who responded to two online surveys said they did not consider their training to be “excellent”.

Most blamed the reduction in working hours introduced in 2009 by the European Working Time Regulations (EWTR).

The majority of trainees believed they should be working more than 48 hours a week and nearly half (49%) agreed that the working week should be between 57-72 hours. Having more time off was not considered important.

Nearly three quarters of respondents (72%) claimed they spent at least a little of their time off seeking further surgical training in theatre or clinic and one in five (20%) spent either a lot or all of their time off gaining surgical experience.

The most important issues for trainees were improved patient care and having more time for training. Consultant interest and support was considered the most important factor determining the quality of training.

A paper on the findings of the surveys is published in the Bulletin of the Royal College of Surgeons (RCS) which is keen to keep concerns about the EWTD restrictions in the headlines as moves to reform the regulations have stalled in the European Parliament.

Ministers in the European Parliament have failed to reach agreement on revision of the regulations so have handed negotiations over to the EU Social Partners – the pan-member state trade union and employer organisations – and extended the deadline for them to come up with a solution to the end of December.

If an agreement is reached, this would be presented as a new directive for adoption by the European Council. If no agreement is reached the EU Commission can decide to either publish new proposals or retain the existing directive in its current form.

RCS president Professor Norman Williams said they were concerned that the EU working time restrictions were continuing to hamper training. Time devoted to surgical training in particular was being squeezed.

An RCS survey in August 2010 revealed that 80% of consultants and 66% of trainees said that patient care has deteriorated under the EWTR while 65% of trainees said that training time had decreased.

Williams said: “The rotas brought in to keep hospitals compliant with the legislation leave senior doctors and juniors little time to establish working relationships which are vital for passing on valuable knowledge.

“The College is calling for flexibility at European and national levels to enable UK surgeons a working week of up to a maximum of, and no more than, 65 hours. This is what surgical trainees have defined as the optimum amount, allowing for safe patient care and good training and experience.”

The authors of the study comment that a combination of a reduction in working hours and the shorter path to consultancy introduced by Modernising Medical Careers has, by some estimates, halved training hours from 30,000 under the old system to just 15,000 currently.

“Quite reasonably there is concern that the current generation of surgical trainees will be less skilled and less competent than their predecessors,” they say.

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One Response to ““Current surgical trainees will be less skilled””

  1. Malcolm Morrison says:

    The EWTRs were never designed for medicine – or, indeed, any other profession. I know of no ‘successful’ person in any profession – or, indeed, in any other walk of life – who only works (or worked on the ‘way up the ladder) 48hrs per week! They were, obviously, going to be a serious problem from the beginning; sadly our ‘leaders’ (both in the profession and in Parliament) chose to turn a Nelsonian eye (or behave like ostriches) – hence the present problems.

    The RCS has been attempting to get some changes to the Regulations for a few years now; but with no real result. As the article above shows, the EU Parliament appears to be unable to make a decision – thank God they are not in clinical practice!

    If we, the future patients, want to have safe, experienced surgeons to treat us in the future, when we need them, the time for action is NOW. Maybe now is the time for UDI (Uilateral Declaration of Independence – as enacted by Rhodesia many years ago); in other words, perhaps we should ‘go it alone’ and let The EU ‘prosecute’ us for providing a proper standard of care for patients and training for junior doctors.
    Retired Orthopod

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