No time to train the surgeons

Editor—In New Zealand in 1985 junior doctors' working hours fell from an average of well over 80 hours a week to less than 58 hours a week within a year.¹ This helped satisfy concerns that quality of care was adversely affected by fatigue caused by excessive hours. Several problems quickly became apparent, most of them similar to those outlined in the editorial by Chikwe et al.²

For basic surgical trainees the impact of such reforms on training is demoralising. Many of the British hospitals I have worked at are planning to change their registrars and senior house officers to full shift, resident on-call rotas in August 2004 to comply with the European Working Time Directive and New Deal. Instead of spending most operating lists with their consultants and participating as part of a team in regular ward rounds and clinics, junior doctors will be moved to rotas.

In New Zealand the average training time for residents has lengthened to up to eight years,³ largely in response to the impact on training of reduced working hours and shift systems. That the chief medical officer is contemplating reducing the overall length of training in the United Kingdom at the same time as hospital trusts are reducing working hours of surgical training by over 80% is surprising.

Overseas surgical trainees need to review their future in the United Kingdom as quality of life has been obtained at the expense of quality of training.