Basic surgical training outcomes in the era of the EWTD

2006 ◽  
Vol 88 (6) ◽  
pp. 206-207 ◽  
Author(s):  
BM Frost ◽  
C Beaton ◽  
AN Hopper ◽  
MR Stephens ◽  
WG Lewis
Keyword(s):  
Surgical Training ◽  
Medical Profession ◽  
Junior Doctors ◽  
Training Outcomes ◽  
Mixed Response ◽  
Surgical Trainees ◽  
European Working ◽  
The Uk ◽  
Working Time Directive ◽  
The New Deal

The European Working Time Directive (EWTD) represents the latest challenge to surgical training in the UK, following Calmanisation and the implementation of the New Deal on junior doctors' hours. Compliance with the EWTD in the UK demands shift working patterns and as such it has received a mixed response from the UK medical profession. While physicians in training are relatively content with the regulations of the EWTD, surgical trainees have voiced concerns regarding the potential impact of an altered working week on their clinical experience and training as well as quality of life.

The Lost Generation: Impact of the 56-hour EWTD on Current Surgical Training

2010 ◽  
Vol 92 (3) ◽  
pp. 102-106 ◽  
Author(s):  
CR Chalmers ◽  
S Joshi ◽  
PG Bentley ◽  
NH Boyle
Keyword(s):  
Shift Work ◽  
Surgical Training ◽  
New Deal ◽  
Working Hours ◽  
Lost Generation ◽  
Surgical Trainees ◽  
European Working ◽  
Working Time Directive ◽  
Training Opportunities ◽  
The New Deal

The reform of specialist surgical training – the New Deal (1991), the Calman report (1993) and the implementation of the European Working Time Directive (EWTD, 1998) – has resulted in shorter training periods with reduced working hours. The Calman reform aimed to improve and structure training with regular assessment and supervision whereas the New Deal and the EWTD have concentrated predominantly on a reduction in hours. The adoption of full or partial shift work to provide surgical cover at night compliant to a 56-hour working week, as stipulated by phase one of the EWTD, has resulted in daytime hospital attendance for surgical trainees of an average three days per week despite almost universal acknowledgement of the limited training opportunities available at night.

The effect of the EWTD on surgical SpRs: a regional survey

2008 ◽  
Vol 90 (2) ◽  
pp. 68-70 ◽  
Author(s):  
K Grover ◽  
M Gatt ◽  
J MacFie
Keyword(s):  
Rest Period ◽  
Working Time ◽  
Junior Doctors ◽  
The European Union ◽  
Regional Survey ◽  
Surgical Trainees ◽  
European Court ◽  
European Working ◽  
The Uk ◽  
Working Time Directive

The implementation of the European Working Time Directive (EWTD) has changed the way surgical training is delivered in the European Union. The Jaeger ruling by the European Court of Justice states that health service employers must guarantee an 11-hour rest period within any 24-hour time period, while the SiMAP ruling has enshrined the concept of all time spent at work being classified as working time. To comply with these rulings, as of August 2004 most NHS Trusts across the UK have implemented shift systems for junior doctors. Numerous factors influence an individual's ability to adapt to working shifts and this has major implications both for patients and for surgical trainees.

scholarly journals The EWTD: friend or foe to quality patient care?

2006 ◽  
Vol 88 (9) ◽  
pp. 318-319
Author(s):  
MBS Brewster ◽  
R Potter ◽  
D Power ◽  
V Rajaratnam ◽  
PB Pynsent
Keyword(s):  
Patient Care ◽  
Medical Staff ◽  
Junior Doctor ◽  
European Working Time Directive ◽  
Junior Doctors ◽  
Out Of Hours ◽  
Quality Patient Care ◽  
European Working ◽  
The Uk ◽  
Working Time Directive

For the last few years all the hospitals in the UK have been changing junior doctors' rotas to become compliant with the European Working Time Directive (EWTD). The first stage, requiring a junior doctor to work a maximum of 58 hours per week averaged over a 6-month period, became law in August 2004. In addition to new posts for junior doctors there have been schemes to facilitate the transition, such as the Hospital at Night programme. This was designed to use the minimum safe number of doctors from appropriate specialties with supporting medical staff to cover the hospital out of hours. It was required to make the most efficient use of this team and allow the junior doctor rotas to be compliant with the appointment of as few new posts as possible.

Are patients happy with SCPs operating?

2006 ◽  
Vol 88 (3) ◽  
pp. 101-103 ◽  
Author(s):  
R Moorthy ◽  
J Grainger ◽  
A Scott ◽  
JW Powles ◽  
SG Lattis
Keyword(s):  
New Deal ◽  
Junior Doctors ◽  
Process Of Change ◽  
Out Of Hours ◽  
European Working ◽  
Shift Pattern ◽  
Full Shift ◽  
Working Day ◽  
Working Time Directive ◽  
The New Deal

The traditional model of surgical service is in the process of change. Classically, a consultant surgeon would have the services of an SpR, staff and associate specialist (SAS) and SHO in clinic and theatre. The implementation of the New Deal and the European Working Time Directive has led to a significant reduction in the number of hours worked by junior doctors. Consequently, nearly all SHOs are working a full-shift pattern and most SpRs are moving onto full-shift rotas to ensure out-of-hours service is maintained. This reduction in the number of junior doctors available during the normal working day has increased the development of extended roles for non-medical professionals.

scholarly journals Surgical anatomy in the age of EWTD and ISCP

2008 ◽  
Vol 90 (7) ◽  
pp. 245-245
Author(s):  
Vishy Mahadevan
Keyword(s):  
Surgical Training ◽  
Surgical Anatomy ◽  
Working Time ◽  
European Working Time Directive ◽  
Medical Careers ◽  
European Working ◽  
The Face ◽  
Considerable Impact ◽  
The Uk ◽  
Working Time Directive

Four major new initiatives being implemented nationally are set to have a considerable impact on the nature of surgical training in the UK. When fully operational, these developments will alter the face of surgical training: the European Working Time Directive (EWTD), Modernising Medical Careers (MMC), the Intercollegiate Surgical Curriculum Programme (ISCP) and the new MRCS examination.

scholarly journals Future of Vascular Surgical Training: The Trainees' Views

2008 ◽  
Vol 90 (2) ◽  
pp. 96-99 ◽  
Author(s):  
Toby Richards ◽  
Keith Jones
Keyword(s):  
Vascular Surgery ◽  
Surgical Training ◽  
General Surgery ◽  
Endovascular Aneurysm Repair ◽  
Endovascular Techniques ◽  
European Working ◽  
The Uk ◽  
Aneurysm Repair ◽  
Working Time Directive ◽  
Future Work

INTRODUCTION In the UK, surgical training includes all aspects of general surgery. Vascular surgery is not an independent specialty. We wished to assess the views of vascular trainees in UK on the future of vascular surgery and training. MATERIALS AND METHODS Trainees were surveyed in 2003, 2004 (after introduction of the European Working Time Directive) and 2005, concentrating on four areas – future practise of vascular surgery, role of endovascular training, vascular specialisation and future training. RESULTS The majority of trainees want to practise vascular surgery alone. In 2003, 80% thought training should include endovascular techniques. By 2005, all trainees regarded training as mandatory as endovascular techniques would represent a significant part of their future work. Opinion changed on training; from 4 years general then 2 years vascular surgery (qualification in general surgery) to 2 years general and 4 years vascular surgery (specialist qualification in vascular surgery; P < 0.0001). Opinion also changed, that vascular surgery should spilt from general surgery to form its own speciality (P < 0.0007). CONCLUSIONS Trainees now regard training in endovascular techniques and endovascular aneurysm repair as mandatory. The majority wish to specialise from general surgery and achieve a separate qualification in vascular surgery.

scholarly journals A Critical Appraisal of the Evidence of Current Methods of Assessment for Surgical Trainees

2013 ◽  
Vol 95 (6) ◽  
pp. 7-11
Author(s):  
AJ Batchelder ◽  
MJ McCarthy
Keyword(s):  
Surgical Training ◽  
Critical Appraisal ◽  
Junior Doctors ◽  
The Past ◽  
Medical Careers ◽  
Surgical Trainees ◽  
The Uk ◽  
Supervision And Training ◽  
And Training

Over the past decade training pathways in the UK have been subject to extensive changes. Concerns regarding the supervision and training of junior doctors led to a number of reforms that were implemented through the Modernising Medical Careers programme and these mandated formalisation of curricula for all specialties. Consequently, the surgical royal colleges of the UK and Ireland designed the Intercollegiate Surgical Curriculum Programme (ISCP), which delineates the framework for surgical training from core trainee level through to the award of a Certificate of Completion of training.

scholarly journals The EWTD 'triple whammy': hitting surgical trainees where it hurts

2007 ◽  
Vol 89 (1) ◽  
pp. 26-28 ◽  
Author(s):  
RM Heath ◽  
TCS Gate ◽  
CM Halloran ◽  
M Callaghan ◽  
MT Paraoan ◽  
...  
Keyword(s):  
Working Hours ◽  
Training System ◽  
Training Time ◽  
Working Lives ◽  
Surgical Trainees ◽  
European Working ◽  
Trainee Surgeon ◽  
Competency Based ◽  
The Uk ◽  
Working Time Directive

Surgical training in the UK has undergone a revolution following Calmanisation and the implementation of the European Working Time Directive (EWTD). The former envisaged that reduced training time would be compensated for by a more structured, competency-based training system centred upon surgical consultant supervision and regular assessment. The EWTD on the other hand aims to improve the working lives of hospital doctors and to improve patients' safety, as well as to comply with EU law by reducing working hours to 56 by August 2004 and further to 48 hours by 2009. No trainee surgeon can now work longer than 13 hours without rest.

General surgical training in the Netherlands

2007 ◽  
Vol 89 (3) ◽  
pp. 92-93
Author(s):  
J Veldkamp
Keyword(s):  
The Netherlands ◽  
Surgical Training ◽  
European Working Time Directive ◽  
Independent Practice ◽  
Orthopaedic Trauma ◽  
Medical Careers ◽  
European Working ◽  
General Surgeons ◽  
The Uk ◽  
Working Time Directive

Miss Veldkamp has the advantage of having trained in both British and Dutch hospitals. Entry into Dutch surgical training is as hard as the Modernising Medical Careers (MMC) hurdles: in the former case it is gained by research degree and publication or as a 'noticeable' SHO. Overall, the level of competence achieved by the Dutch scheme would appear to be a little behind that of our own training, although that may well change following MMC. On completion of training a number of Dutch trainees take up a fellowship post before assuming independent practice…shades of the future in the UK? In such a sophisticated country as the Netherlands it is an anomaly for general surgeons to continue to manage orthopaedic trauma. Yet again, another EU country appears to have cocked a snook at European Working Time Directive.

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