Junior doctors look forward to shorter hours
BMJ 1998; 317 doi: https://doi.org/10.1136/bmj.317.7171.1473a (Published 28 November 1998) Cite this as: BMJ 1998;317:1473All rapid responses
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EDITOR - As junior doctors we indeed look forward to the proposal of
the European Commission on working time (1). We strongly hope that the
European Commission, which has described the situation of doctors-in-
training in certain European countries, including Belgium, as merely
criminal (2), may succeed in regulating the working time for doctors-in-
training, a matter in which the health care sector itself has repeatedly
failed. The regulations, as proposed by the European Commission, will
undoubtedly be supported by the public. Patients want to see a competent,
friendly and alert doctor. It has been clearly proven that excessive
working hours has the same effect as drinking alcohol on overall
performance (3). Studies clearly showed that skills are significantly
affected by sleep deprivation (4).
We do not agree with the views of A. Hobart and S. Thornton (1). Not
long day and night shifts will make a doctor in training a good one; it is
rather the quality of the training itself that counts. We and our
overworked colleagues in the majority of European countries simply don't
have any time left for study and research. We also have problems to
establish a positive environment with a normal family life, which should
give the energy to be a good doctor in daily (and nightly) practice. The
current long working hours just prevent good training and are only
intended to guarantee a good night rest for often well-paid specialists in
many hospitals. Therefore, the proposal of the European Commission should
be implemented as soon as possible. We all need to rethink the specific
tasks of doctors in training and of those who have already finished their
training. The proposal does not bring any problem for patient care if
addressed properly. On the contrary, it provides a unique opportunity to
improve the quality of health-care during the night and in weekends, and
to make better doctors in future generations, from a scientific as well as
from a human point of view.
Rik Lories, M.D.
Dirk Ramaekers, M.D.
Michiel Thomeer, M.D.
Leuvense Vereniging Geneesheer Assistenten
(Leuven Association of Doctors in Training)
Herestraat 49
B-3000 Leuven, Belgium
References
1. Beecham L. Junior doctors look forward to shorter hours. BMJ. 1998.
317:1473.
2. Chanterie R. Debate of the European Parliament, july 2, 1998.
3. Dawson D, Reid K. Fatigue, alcohol and performance impairment.
Nature. 1997. 388:235.
4. Taffinder NJ, McManus IC, Gul Y., Russel RCG, DarziA. Effect of
sleep deprivation on surgeons dexterity on laparoscopic simulator. Lancet.
352 (9135): 1191.
Competing interests: No competing interests
Junior doctors look forward to shorter hours
Dear Sir,
We have followed with increasing concern the various reports
published in the British Medical Journal over the last few years related
to Junior doctors hours. As always there are two sides to every story and
unfortunately the political drive to reduce the hours of work still
further, as reported by Linda Beecham (1), has overshadowed the very real
concern many trainees and trainers feel in relation to this current trend.
In a recent anonymous questionnaire carried out in the Royal
Infirmary, Edinburgh of 134 junior dosctors (80 prhos/shos and 54 SpRs)
60% considered the current hours of work and length of training inadequate
for their needs. When asked if the actual quality of training in the time
available was
improved, 49% still considered this period insufficient. When asked the
number of hours they wished to work each week to gain adequate experience
83% of doctors wanted to work 72 hours, with 93% of the surgical SpRs
requesting 90 hours.
Although we entirely accept that this study population is highly
selective, coming as it does from a major teaching hospital, we ignore
these concerns from the consultants of tomorrow at our peril. Surely it is
time to realise
that the hours of work and training period required for different areas of
Medicine vary and as such, rigid legislation, from whatever source, must
be strongly challenged by the postgraduate training bodies.
Yours faithfully
Claire Bourne
Senior House Officer A&E
Simon Paterson-Brown
Postgraduate Surgical Tutor
1. Beecham L. Doctors look forward to shorter hours. BMJ 1998;
317:1473
Competing interests: No competing interests