Andrew Hartle and Sarah Gibb, both from the Association of Anaesthetists of Great Britain and Ireland, think that 48 hours a week is enough time to train doctors. The crux of their argument is that it happens in Norway, so why not here.
The evidence that the anaesthetists have collected about their trainee’s training suggests that, after redesigning the service, there is “no evidence of any reduction in anaesthetic trainees’ caseload or access to training opportunities and shows consistent exam success rates, no increase in referrals to regulatory bodies, and a reduction in sick leave among trainees since the regulations were introduced”
Arguing no is Andrew Goddard, a registrar from the Royal College of Physicians. He says: “It may well be that we can train many types of doctor within the current system, but for hospital medicine this is not the case . . . Some 44% of doctors completing core medical training report that they are not sufficiently trained to be a higher specialist trainee. When asked why they haven’t had enough training, most cite excessive service pressures.”
I think the problem is captured by both sides, that within the current system it’s impossible to train doctors within 48 hours—but that doesn’t meant it is, a priori, an impossibility.
Have a listen to this podcast interview with Craig McIlhenny, director of the Faculty of Surgical Training at the Royal College of Surgeons of Edinburgh. He thinks that the days of training happening by some sort of knowledge osmosis are gone, and that it’s time to professionalise the endeavour—reward good trainers and encourage the less good to improve.
I expect a 48 hour working week is beyond the wildest dreams of the doctors of MSF, as they battle to help those in disaster zones around the world. Our attention is focussed on the Ebola virus disease outbreak in west Africa, but as you’ll read in Jane Feinmann’s article, they are still at work in Syria, Haiti, Afghanistan, and elsewhere.
This is partially why The BMJ has chosen MSF as our Christmas charity—so please dig deep. Donating is easy, and can literally take seconds. Here’s how:
MSF’s volunteer doctors need your support: please give generously
· £38 can pay for a suit to protect against Ebola
· £53 can send a doctor to the field for a day
· £95 can provide a year’s treatment for someone with HIV/AIDS
· £153 can provide life saving blood transfusions for three people
· Donate online
· Donate by phone in the UK: 0800 408 3897
· Donate £5 by text message: text “Doctor” to 70111*
· *UK mobile networks only. You will be charged £5, plus your standard network rate. MSF will receive 100% of the £5 donation. If you have any questions please call +44 (0)207 404 6600.
Duncan Jarvies is multimedia producer for The BMJ.