Wendy Reid's response tries to explain why all hospitals should be
able to adapt to the new circumstances without a problem, if only it were
that easy in reality.
There is clearly a great problem in recruiting the numbers of doctors
needed to fill the new EWTD compliant rotas; this problem is much more
marked in more peripheral hospitals where trainee numbers are often lower
and where it is much harder to fill non training jobs. This has led to
abundant rota gaps (1), demoralised and exhausted doctors, training
problems and concerns for patient care.
One only gets meaningful answers if one ask meaningful questions;
meaning that some would say that the PMETB survey is not worth the paper
it is written on, soft vague questions that obtain no hard comparable
responses will always be a blunt tool for assessing what is genuinely
happening regarding medical training. It is arguable that there are
significant problems with training that are not currently being addressed
(2). While attempts to improve the quality of training are noble, they
should not detract from the fact that if the meaning of the title
'consultant' is to be maintained then training will have to be lengthened
with the reduced hours as a result of EWTD.
Quite simply more doctors are needed to fill these rota gaps.
Unfortunately as has been pointed out by Dr Fisken (3) the government’s
discrimination against non EU doctors has made it much harder to fill
these posts or hire locum cover, harder than ever before I would say.
Rapid Response:
problems ignored
Wendy Reid's response tries to explain why all hospitals should be
able to adapt to the new circumstances without a problem, if only it were
that easy in reality.
There is clearly a great problem in recruiting the numbers of doctors
needed to fill the new EWTD compliant rotas; this problem is much more
marked in more peripheral hospitals where trainee numbers are often lower
and where it is much harder to fill non training jobs. This has led to
abundant rota gaps (1), demoralised and exhausted doctors, training
problems and concerns for patient care.
One only gets meaningful answers if one ask meaningful questions;
meaning that some would say that the PMETB survey is not worth the paper
it is written on, soft vague questions that obtain no hard comparable
responses will always be a blunt tool for assessing what is genuinely
happening regarding medical training. It is arguable that there are
significant problems with training that are not currently being addressed
(2). While attempts to improve the quality of training are noble, they
should not detract from the fact that if the meaning of the title
'consultant' is to be maintained then training will have to be lengthened
with the reduced hours as a result of EWTD.
Quite simply more doctors are needed to fill these rota gaps.
Unfortunately as has been pointed out by Dr Fisken (3) the government’s
discrimination against non EU doctors has made it much harder to fill
these posts or hire locum cover, harder than ever before I would say.
1. Optimising working hours to provide quality in training and
patient safety. Association of Surgeons in Training (ASIT). January 2009.
(http://www.rcseng.ac.uk/news/surgeons-call-for-solution-on-patient-safety
-and-future-training-as-doctors-hours-are-slashed).
2. British surgeons' experiences of mandatory online workplace-based
assessment. Pereira E, Dean B. J R Soc Med 2009;102:287-293.
3. Still not enough doctors. Fisken R. BMJ rapid response January 2010.
Competing interests:
None declared
Competing interests: No competing interests