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Working time rules reduce surgery experience for trauma and orthopaedics trainees

Authors: Helen Jaques 

Publication date:  17 May 2012


The 48 hour week introduced by the European Working Time Directive has significantly reduced the total number of operations and number of elective procedures that trauma and orthopaedic surgery trainees are able to perform, a small study at Nottingham University Hospitals NHS Trust indicates (Ann R Coll Surg Engl (Suppl) 2012;94:156-8, doi:10.1308/147363512X13311314195411).

The 35 specialist registrars and fellows analysed in the study completed 13% fewer orthopaedic operations, such as hip fracture surgery and knee arthroscopic surgery, in the year after the introduction of the working time regulations in August 2009 than in the year before (P=0.004).

When the operations were broken down into type of procedure, trainees were found to have undertaken 18% fewer elective operations in the year after the introduction of the working time regulations and 6% fewer trauma operations (P=0.018 and P=0.47, respectively).

Both the quantity and the intensity of operative exposure have been reported to have an effect on the acquisition of surgical skills, say the authors, so these findings have implications for the safety of patients and the provision of good quality training for orthopaedic surgeons.

Helen Jaques news reporter BMJ Careers

 hjaques@bmj.com

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