Letters Doctors’ hours

Consider physicians’ training

BMJ 2009; 339 doi: http://dx.doi.org/10.1136/bmj.b5592 (Published 31 December 2009) Cite this as: BMJ 2009;339:b5592
  1. Michael Sherratt, consultant clinical neurophysiologist1
  1. 1Luton and Dunstable Hospital, Luton LU4 0DZ
  1. msherratt{at}nhs.net

    It was illuminating to discover that in Belgium the emphasis is on achieving surgical competence, with worked hours a secondary consideration.1 But why have most of the recent discussions centred on surgical training?2 3 4

    Competence in internal medicine is demanding intellectually, but perhaps less easy to verify than surgical competence. In neurophysiology we as physicians are referred cases from nearly all specialties . Conversations with referring junior doctors to clarify reasons for and expectations from electroencephalography and electromyography more often than not show that the doctor who wrote the request (a) is not available because of shift working, (b) does not know the patient in question, (c) does not know what the implications of the test result might be, and (d) has not constructed a differential diagnosis.

    This fragmented exposure to case material is denying the essential apprenticeship and learning experience needed by these excellent young doctors to produce competent physicians. This attenuated training is equally as serious as the issues surrounding surgery.


    Cite this as: BMJ 2009;339:b5592


    • Competing interests: None declared.


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