Six of the Best, General 19

Aims: Hours of work of junior doctors have been progressively cut over the last few years, while the period of surgical training has remained fixed and as a result there are concerns that surgical trainees are not receiving adequate training. We studied the impact of changing on-call rota to a partial shift rota on the operative experience of junior surgeons in a district general hospital. Methods: We retrospectively looked at operative experience (excluding endoscopies and minor procedures) gained over 8 months. For the first 4 months, junior staff consisted of four specialist registrars (SPR) and one senior house officer (SHO) working a one in five on-call rota contracted for 72 h week−1. In the following 4 months, junior staff consisted of four specialist registrars and two SHOs (one additional SHO covering nights and weekends) working a partial shift rota contracted for 64 h week−1. The total number of operations performed (elective and emergency procedures) were recorded by analysis of trainees log books. Results: The results are summarized below. Specialist registrars' total operative experience declined by 10 per cent; elective procedures declined by 11 per cent and emergency procedures declined by 5 per cent. No significant differences were seen in difficulty of operation or level of supervision. SHOs experience increased, but not as much as expected given that two were employed compared to one in the first period. Conclusion: The reduction in hours has made a significant impact on operative training exposure for specialist registrars.