With the introduction of the New Deal and the Calman Report, the duration of higher specialist training will be halved.
We have examined the effect of reduced on-call rotas on exposure to relatively uncommon out-of-hours emergencies in cardiothoracic surgery.
Operations for post-infarction ventricular septal defect, aortic dissection or transection, oesophageal perforation and pulmonary embolus performed out-of-hours between 1990 and 1995 were identified from hospital records.
Over 6 years, the period of higher specialist training in cardiothoracic surgery, a trainee would see seven aortic emergencies on a 1 : 2 rota, four on a 1 : 4 rota and two on a 1 : 6 rota.
These figures provide a powerful argument in support of the English Clause which allows trainees to be available for 83 hours a week, equivalent to a 1 : 4 rota, rather than 56 hours a week, equivalent to a 1 : 6 rota under the New Deal.
This may need supplementation by a mechanism whereby trainees are'on call for training.
Mots-clés Pascal : Chirurgie, Coeur, Thorax, Equipe soignante, Service urgence, Audit, Travail, Heure, Surcharge, Distribution, Analyse statistique, Homme, Royaume Uni, Europe, Appareil circulatoire pathologie, Organisation santé
Mots-clés Pascal anglais : Surgery, Heart, Thorax, Health care staff, Emergency department, Audit, Work, Hour, Overload, Distribution, Statistical analysis, Human, United Kingdom, Europe, Cardiovascular disease, Public health organization
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0300945
Code Inist : 002B25E. Création : 16/11/1999.