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EWTD a challenge or threat to training?
- rachna shankar (22 December 2005)
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Training in Anaesthesia in the UK – an overview by a trainee Anaesthetist
- Senthil Kumar Muthu (5 December 2005)
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rachna shankar, SHO/Anaesthetics Royal Liverpool Hospital
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It is widely accepted fact that WTD has affected training of junior doctors,more in a negative way. New Deal and later EWTD had caused uproar and worries amongst the authorities and individuals responsible for training. And unfortunately their worries are becoming reality. Another important aspect of shifts which cannot be overlooked is patient continuity. Repeated surveys conducted both within UK hospitals as well as outside UK has shown similar declining pattern of work of junior doctors, leading to inexperience. To support this analysis we quote our experience .A questionnaire survey of junior doctors was conducted in a DGH in North West of England, 62 junior doctors in surgical specialities were questioned about the adequacy of their training and the level of satisfaction with their work pattern after Aug2004.Also work at SHO level was compared before and after Aug 04 over 2 month period. We concluded : 75% preferred to be noncompliant with EWTD and agreed on potential negative impact on their training. A greater reduction of 22% in the no. of cases conducted by the SHO was noted Similar studies in past have quoted up to 18% decrease in the caseload of SpR And a 11% decrease in weekly training lists of a junior doctor Does this prove predictions by rcseg feb 2003: EWTD would affect continuity of patient care and restricted hrs would cost them their training. Though most of us agree that this continuing decline of cases handled is a cause of great concern but do we have a way out of this dilemma? Royal College had also expressed concern over the training post EWTD but where does this lead? With both the trainers and the trainees being dissatisfied with the pattern of training after Aug 2004, a further reduction in 2009 definitely could be a real threat to trainees. Rachna shankar Email: rachnas@rediffmail.com. Conflict of Interest:None declared |
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Senthil Kumar Muthu, Anaesthetist Arrowe Park Hospital
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Editor – I read with interest the article, Influence of changing work patterns on training in anaesthesia: an analysis of activity in a UK training hospital from 1996 to 2004 by authors S.M Underwood and A.K McIndoe. I thank the authors for pointing out the difference in training for the SHO’s and SpR’s in anaesthesia over an 8-year period. But, I do not think the level of supervision of the trainees by consultants remains the same throughout England. There is a difference in the level of supervision between the DGH’s and the University hospitals. Many DGH’s have limited number of consultants who are unable to supervise all the cases done by the on call trainees. I believe, even though the SHO’s and SpR’s manage limited number of patients due to the new working time directive, the trainees in DGH’s have more hands on experience and get to do more cases on their own. The other aspect is that, the authors did not mention about the number of overseas-qualified trainees with anaesthetic qualifications like MD or DA over the 8-year period of analysis. Overseas trainees, many of them who are sponsored by the Royal College of Anaesthetists, start their anaesthetic training in the United Kingdom with at least 2-3 years of previous anaesthetic experience abroad. If the authors have included the number of cases done by these trainees the figures would have been different. Definitely this experience counts towards the competency of the individual trainees. Senthil Kumar Muthu SHO in Anaesthetics Arrowe Park Hospital Wirral, UK E-mail: sensathiya@yahoo.com References 1. S.M.Underwood, A.K.McIndoe. Influence of changing work patterns on training in anaesthesia: an analysis of activity in a UK teaching hospital from 1996 to 2004. Br J Anaesth 2005: 5: 616-621 2. McIndoe AK, Underwood SM. The current state of anaesthetic training-a detailed analysis in a UK teaching hospital. Br J Anaesth 2000; 84: 591-5 Conflict of Interest:Training in Anaesthesia |
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