Factors relating to working hours restriction that have impacted the professional identity of trainees in the last decade

2021 ◽  
Vol 82 (3) ◽  
pp. 1-10
Author(s):  
Soumya Mukherjee ◽  
James Meacock ◽  
Eleanor Kissane ◽  
Debasish Pal
Keyword(s):  
Identity Development ◽  
Professional Identity ◽  
Medical Training ◽  
Working Hours ◽  
Junior Doctors ◽  
Clinical Experiences ◽  
Postgraduate Medical Training ◽  
European Working ◽  
Working Time Directive ◽  
The Impact

Ever-developing changes to the working hours of junior doctors by the European Working Time Directive, the junior doctor contract of 2019 and most recently the COVID-19 pandemic have impacted the professional identity of doctors. There has been little investigation into its influence on the multifaceted aspects of postgraduate medical training, which feeds into how trainees consider themselves professionally and the concept of professional identity or ‘being a doctor’. A review of the medical, socio-political and educational literature reveals that the impact on the professional identity development of trainees is influenced by several perspectives from the trainee, trainer and the public. Gross reduction in working hours has no doubt decreased the raw volume of clinical experiences. However, to counteract this, smarter learning processes have evolved, including narrative reflection, supervised learning events, and a greater awareness of coaching and training among trainers.

scholarly journals Near-misses and Missed Opportunities: Poor Patient Handover In General Surgery

2008 ◽  
Vol 90 (3) ◽  
pp. 96-98 ◽  
Author(s):  
M Tokode ◽  
L Barthelmes ◽  
B O'Riordan
Keyword(s):  
General Surgery ◽  
Working Hours ◽  
Junior Doctors ◽  
Learning Potential ◽  
Missed Opportunities ◽  
Near Misses ◽  
Medical Careers ◽  
European Working ◽  
Working Time Directive ◽  
Patient Handover

Since the introduction of shift systems for junior doctors as part of the European Working Time Directive, different teams of doctors look after patients over the course of a day. This requires ro bust handover mechanisms to pass on inf ormation between differ ent teams of doctors to avoid misses and near-misses in patients' care. Modernising Medical Careers shortens the placements of doctors in foundation programmes in general surgery to four months compared with six-month placements as pre-registration house officers in the past. The reduction in working hours will therefore adv ersely aff ect exposur e and experience of junior doctors in general surg ery unless the learning potential of time spent at work is maximised.

Quinsy trainer

2007 ◽  
Vol 121 (12) ◽  
pp. 1194-1196 ◽  
Author(s):  
J Murphy ◽  
J T Murphy ◽  
A Sama
Keyword(s):  
Low Cost ◽  
Working Hours ◽  
Peritonsillar Abscess ◽  
Junior Doctors ◽  
The European Union ◽  
Simple Method ◽  
The United Kingdom ◽  
Medical Careers ◽  
European Working ◽  
Working Time Directive

AbstractThe implementation of the European Working Time Directive, from the Council of the European Union (93/104/EC), in August 2004 has provoked a change in the working hours of junior doctors in the United Kingdom. With the evolution of the subsequent cross-cover arrangements combined with the modernising of medical careers, training is becoming increasingly important. Here we present a simple method of teaching junior doctors the skills and competencies required to aspirate a peritonsillar abscess or ‘quinsy’. The model is easy to construct, low cost and reusable.

scholarly journals Impact of the European Working Time Directive on trainees and trainers 3 years post-implementation

2013 ◽  
Vol 37 (9) ◽  
pp. 286-289
Author(s):  
Farshad Shaddel ◽  
Subimal Banerjee
Keyword(s):  
Working Time ◽  
European Working Time Directive ◽  
Junior Doctors ◽  
Positive Effects ◽  
European Working ◽  
Negative Effect ◽  
Negative Impacts ◽  
Working Time Directive ◽  
The Impact

Aims and methodTo assess the views of trainees and trainers of the impact of the European Working Time Directive (EWTD). The study was conducted in two stages. First, a qualitative survey of trainees and trainers in the Oxford Deanery was carried out on the positive and negative aspects of the EWTD to identify key areas. Second, a self-completed questionnaire was developed separately for trainees and trainers and the results collated. Twenty trainers and nineteen trainees took part in the study.ResultsAbout 70% of trainees and trainers were aware of the EWTD objectives. Ninety per cent of trainers and 30% of trainees believed that the introduction of the EWTD was a negative development. Compared with 42% of trainees, 80% of trainers believed that the EWTD had not improved the quality of care and instead had a negative effect on doctor–patient alliance and continuity of care. Although 53% of trainees believed that the quality of training was not compromised by the introduction of the EWTD, 84% of trainers thought otherwise. Less hands-on experience and some doctors' roles being given to other professionals were the most stated negative impacts of the EWTD on the quality of doctors' training. Positive effects of the EWTD from both trainees' and trainers' points of view were a better work-life balance and less burnout for junior doctors.Clinical implicationsThe EWTD may not have been successful in achieving all of its intended objectives. Further studies on different sample groups would help clarify the wider impact of the EWTD.

scholarly journals Perceived impact of EWTD on UK doctors

2009 ◽  
Vol 91 (4) ◽  
pp. 132-134 ◽  
Author(s):  
Ryckie G Wade ◽  
James Henderson
Keyword(s):  
Patient Care ◽  
Working Hours ◽  
Working Time ◽  
European Working Time Directive ◽  
Junior Doctors ◽  
European Working ◽  
Perceived Impact ◽  
Working Time Directive ◽  
A Current

Doctors have historically worked long hours to provide patient care but also to gain experience. Over the last decade, working hours have decreased significantly, and the introduction of the European Working Time Directive (EWTD) has formalised this. In August 2009, junior doctors (but not consultants) will be limited to a 48-hour working week (see http://www.dh.gov.uk/en/Managingyourorganisation/Huma nresourcesandtraining/Modernisingworkforceplanninghome/Europeanworkingtimedirective/index.htm). There are concerns at all levels of the profession that doctors will not be adequately trained to function at the standard of a current NHS consultant. Doctors with the least experience make the most errors and familiarity with situations and equipment is directly related to competency.

scholarly journals Hospital at Night: Not for ENT?

2006 ◽  
Vol 88 (4) ◽  
pp. 134-136 ◽  
Author(s):  
DD Pothier ◽  
S Ahluwalia ◽  
P Monteiro
Keyword(s):  
Patient Care ◽  
Continuity Of Patient Care ◽  
Working Time ◽  
European Working Time Directive ◽  
Junior Doctors ◽  
Consultant Surgeon ◽  
European Working ◽  
After Hours ◽  
Working Time Directive ◽  
The Impact

The introduction of the European Working Time Directive has meant a reduction in the number of hours that junior doctors may spend at work. The impact that this legislation will have on training and the continuity of patient care may be significant. In an attempt to reduce the number of doctors required to look after patients after hours, the Hospital at Night programme has been introduced. The basis of the project is to have a team of generically skilled surgeons on call to handle emergencies and routine ward work from all surgical specialties. The reasoning behind this move is that most SHOs have sufficient training to deal with most surgical problems; any more advanced problems are to be referred to the SpR or consultant surgeon for that specialty.

scholarly journals Weekly working hours for Norwegian hospital doctors since 1994 with special attention to postgraduate training, work–home balance and the European Working Time Directive: a panel study

BMJ Open ◽  
2014 ◽  
Vol 4 (10) ◽  
pp. e005704 ◽  
Author(s):  
Judith Rosta ◽  
Olaf G Aasland
Keyword(s):  
Cultural Values ◽  
Postgraduate Training ◽  
Panel Study ◽  
Working Hours ◽  
Working Time ◽  
European Working Time Directive ◽  
Junior Doctors ◽  
European Working ◽  
Hospital Doctors ◽  
Working Time Directive

ObjectivesTo examine the weekly working hours of Norwegian hospital doctors from 1994 to 2012 with special emphasis on the quality of postgraduate training and work–home balance, and in relation to the requirements of the European Working Time Directive (EWTD).DesignPanel study based on postal questionnaires.SettingNorway.ParticipantsUnbalanced cohort of 1300–1600 doctors in 1994, 1995, 1996, 1997, 2000, 2002, 2004, 2006, 2008, 2010 and 2012.Outcome measuresSelf-reported total weekly working hours and whether 45 weekly working hours are too short, sufficient, or too long to meet the quality requirements of obligatory postgraduate training for junior doctors.ResultsFrom 1994 to 2012, the number of weekly working hours was stable for senior (46–47 h) and junior (45–46 h) hospital doctors. In 2012, significantly more senior (27–35%) than junior (11–20%) doctors reported suboptimal work–home balance, defined as working more than 48 h a week. The majority perceived the present situation with an average of 45 h per week for juniors as sufficient for obligatory postgraduate specialist training, but doctors of higher age (OR 1.04, 95% CI 1.01 to 1.08), senior doctors (1.07, 1.04 to 1.11) and doctors working in surgical specialties (OR 1 vs laboratory medicine 0.03, 0.01 to 0.25, internal medicine 0.31, 0.17 to 0.58, psychiatry 0.12, 0.04 to 0.36, paediatrics 0.36, 0.12 to 1.07, anaesthesiology 0.08, 0.02 to 0.39, gynaecology 0.07, 0.01 to 0.56 and others 0.39, 0.04 to 3.56) were more likely to want the work-week to be longer.ConclusionsThe weekly working hours of Norwegian hospital doctors were always below the EWTD requirements. A significant growth of hospital doctor density over the past two decades, national regulations and cultural values might be important factors. Specialty differences in perception of sufficient training time may call for more flexibility in working time regulations.

scholarly journals EWTD: maintaining the pressure

2009 ◽  
Vol 91 (8) ◽  
pp. 258-259 ◽  
Author(s):  
John Black
Keyword(s):  
Medical Association ◽  
Working Time ◽  
European Working Time Directive ◽  
News Item ◽  
Junior Doctors ◽  
Public Concern ◽  
European Working ◽  
Working Time Directive ◽  
First Time ◽  
Radio Programme

The ill-judged introduction of the 48-hour week demanded by the European Working Time Directive (EWTD) was the first news item on every television and radio programme on Saturday 1 August, indicating just how successful the College has been in raising public concern. It was encouraging that the British Medical Association (BMA) speakers were for the first time expressing serious anxiety, largely about the effects on training and about pressure being put on junior doctors to falsify their hours returns. All conversions to the cause are welcome, however late in the day. It is disappointing that the BMA is not yet stressing the dangers to patients, which they are surely hearing about from their members working in the acute specialties.

The changing role of the otolaryngology Senior House Officer

2006 ◽  
Vol 88 (2) ◽  
pp. 66-68 ◽  
Author(s):  
AK Arya ◽  
KP Gibbin
Keyword(s):  
Patient Safety ◽  
Junior Doctor ◽  
House Officer ◽  
European Working Time Directive ◽  
Junior Doctors ◽  
Senior House Officer ◽  
European Working ◽  
Working Time Directive ◽  
Changing Role

The European Working Time Directive (EWTD) has led to a reduction in the number of hours that a junior doctor is allowed to work. The Hospital at Night project aims to reduce juniors' presence at night through more efficient working. Otolaryngology has been considered to be one of the surgical specialties in which generic junior doctors covering more than one specialty could effectively function. The hope is to reduce junior doctors' hours sufficiently without compromising their training or patient safety.

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