Surgical training crisis in UK

Consultant Orthopaedic Surgeon

I don’t normally buy the Observer on Sunday.

A reader refers me to this week's edition, in particular to Page 10 of the Media Observer, where I find:



Clearly, I now realise the Observer is a paper of taste and discrimination, which I shall order immediately.

On a serious note, and strongly relevant to “A doctor writes…” , “A nurse writes” and “The essence of care” is a horrifying report by Jo Revill, the Observer health editor.

Ten to fifteen years ago, the average orthopaedic surgeon would have had approximately 36,000 hours hands-on experience before he was appointed to a consultancy. Dr Andrew O’Brien, a specialist registrar in orthopaedics will have had approximately 8000 hours experience when he becomes a consultant.

In a nutshell (nutcase you might prefer) the new consultant will have three hundred per cent less experience than his older colleagues. So the next time you go into hospital make sure your consultant is aged at least fifty.

Why is this happening? The European Working Time Directive (the progenitor of Hospital at Night) under which junior doctors can only work 56 hours a week including nights on call. This working directive does not, for some reason that is beyond me (and particularly beyond Mrs Crippen who is a consultant), apply to consultants, who can work as many hours as they wish. Which is just as well, as they now have to go in to do the work the registrars used to do. This deskills the registrars and tires the older consultants.

Unlike nurse-specialists, who do not know what they do not know, these trainee surgeons understand that they are lacking in experience. Says Dr O’Brien:

“We will not have the expertise of the current consultants.”

Some of these doctors are going into the operating theatres, unpaid, in their free time to gain more experience. Full marks for effort, guys. Commendable initiative you may think. The government does not.

The trainee surgeons who go voluntarily into the theatres to gain experience, have to lie to their NHS trusts about the hours they work. If they reveal they have exceeded the limit, their hospital becomes liable for financial penalties from the Health and Safety Executive.

New Labour? EC regulations? Does it matter? You could not make it up.

I cannot find the full story on the Internet. I suggest you go out and buy the Observer whilst supplies last.