Out-of-hours work in cardiothoracic surgery : implications of the New Deal and Calman for training.
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.