EWTD hits training across Europe, says GMC

RULES limiting the working week to 48 hours have had a negative effect on training in countries across Europe, according to research by the General Medical Council.

It found that many countries struggled to implement the European Working Time Directive and to compensate for the reduced number of hours available for training. The study looked at the views of European regulators, medical specialty societies, and medical trainees as well as non-European specialty societies.

Countries with traditionally long working hours – such as Portugal and the UK – have had particular difficulty with the directive, the study found. This is due to the role trainees play in managing the day-to-day hospital work. In contrast, countries where trainees have a lesser role in hospital work – such as Italy – found it easier to implement the rules.

Many of the 15 EU countries surveyed on behalf of the GMC reported that the working hours limit means that trainees aren’t exposed enough to procedures and apprentice-style learning, because too much time was being spent on service delivery. The restrictions also forced trainees to choose between classroom-based learning and hands-on experience and are less likely to witness the “trajectory” of a disease in a single patient.

The study found evidence that the EWTD has already harmed UK training. Anaesthesia trainees now take an average of four months, instead of three, to pass the initial competence assessment.

The report concluded: “What this research has shown is just how varied the impacts [of the directive] can be, ranging from emotional effects such as lower morale through to the very tangible risk that restricted hours poses to the quality of training received by trainees and the subsequent effect that this has on their career.

“Furthermore, the evidence from this research suggests that these impacts vary according to specialism, with those working in more practical roles (such as anaesthesia and surgery) bearing the brunt.”