Shifts in opportunities for doctors in training

The health of an individual represents a continuum of events. Therefore health care requires continuity of assessment, planning, and treatment. Is it necessary to have most of the medical care provided by one doctor, or can adequate care be provided by a variety of doctors for each health event? Can continuity of care in hospitals be met by trainee doctors working shifts, and can shift work and reduced hours meet training requirements? These are important questions for teaching hospitals. In most countries where early postgraduate medical training takes place in general hospitals three needs are evident: to define appropriate training requirements for progression to higher levels of practice; to provide the maximum effectiveness of care for the lowest possible cost; and to provide reasonable hours of work for staff in training.1-4 In medicine skills and knowledge are traditionally gained by apprenticeship and experience. 4 5 …