Poor training blamed on EWTD

MANY surgical trainees blame unsatisfactory training on working time regulations, according to new research.

A study published in the Annals of the Royal College of England found many trainees don’t rate their training highly. One of the main factors was the limitations imposed by the European Working Time Directive (EWTD) which restricts an average working week to 48 hours.

Researchers spoke to 310 surgical trainees from across the UK in two online surveys in 2009 and 2010. They were questioned about the impact of the EWTD on work-life balance, and quality of training, as well as other training issues.

The 2010 survey – which had 176 responses – highlighted widespread dissatisfaction with training quality with only 30 per cent of respondents describing their training as excellent.

Fewer working hours was identified as a key factor with 43 per cent of respondents agreeing completely that it was the most important factor contributing to less than excellent training, while 83 per cent agreed in part.

A report in the BMJ highlighted how those who said they were happy with their training valued consultant interest and support most highly.

Almost half the doctors who responded to the survey were in favour of extending the working week to between 57 and 72 hours with only nine approving of the current rules.

And while the 2009 survey, which attracted 134 responses, showed trainees agreed their work-life balance had improved since the EWTD, almost 80 per cent felt patient care had not improved. Almost 80 per cent also felt training time had been curbed since the EWTD was implemented fully in August 2009.

The authors stated: “Although it is outside the scope of this study to demonstrate whether there is an actual deterioration in patient care, this perception is of serious concern and needs urgent address.”

The survey suggested the 48-hour working week rules are often breached with 72 per cent of respondents claiming to spend at least some time off in theatre, while one in five said they spent a lot of time trying to get more surgical experience.

The authors added: “What is most important to these trainees is that opportunities for training are not compromised, and most are of the opinion that the time available for training has been undermined by the [directive].”

These results contrast with findings in other countries such as the US where juniors working an 80-hour week report high levels of satisfaction with training.