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Training within the European Working Time Directive

  • Charles Dixon (a1)
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This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
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BJPsych Bulletin
  • ISSN: 0955-6036
  • EISSN: 1472-1473
  • URL: /core/journals/bjpsych-bulletin
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Training within the European Working Time Directive

  • Charles Dixon (a1)
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eLetters

Training within the European Working Time Directive: Ensuring Experience

Andy R Bickle, SHO in Psychiatry
03 November 2004

Dear Editor,

I share Charles Dixon’s concerns (Psych Bull (Correspondence) Nov 2004, 28, 426) about the limited exposure of SHOs to A & E assessment under new working arrangements ushered in by the European Working Time Directive (EWDT). Anecdotally, the number of assessments done on a night shift has fallen dramatically. In our trust, for example, where one SHO previously covered an A & E serving a population of 650,000 and did anything up to a dozen assessments over twelve hours there are now two SHOs and two senior nurses sharing the assessments (and to be honest, the nurses usually do the majority). My personal experience definitely does not concur with the findings of Moore & Willmott (Psych Bull, Oct 2004) that nurse-led triage/assessment teams actually increase junior doctors' workload.

These initiatives to improve working conditions are of course very welcome and overdue, but at the risk of sounding like an old-timer with rose-tinted specs, I am concerned that future SHOs will gain inadequate experience of emergency assessments. In particular, they may be underprepared for life as a registrar and being on the other end of the phone call determining whether the homeless alcoholic making vague suicidal threats should be given a bed for the night. But I do think there is a straightforward solution to this problem. Simply make it a requirement for SHOs to complete a target number of a certain common assessments before progression to Membership or SPR posts, similar to ECT experience at present. Trainees could, for example, be required to have assessed tencases of deliberate self harm before Part Is and another ten before Part IIs. Completion of the task could be certified at a later time by the duty Specialst Registrar with whom the assessment was discussed. This shades towards the kind of competency-based assessment we can expect in a few years anyway and there already exists the vehicle to store these records in the College's Trainee Log Book (which can feed back into professional development at job appraisals).

For many of us this may bring back tedious memories of pestering our teachers for lists of signatures on the completion of every little procedure in clinical years of medical school, but I think we'd get over it.

Yours,

Andy Bickle

SHO in PsychiatryWestminster House Wells RdNottinghamNG3 6AA

ReferenceMoore A.P. & Willmott S. (2004) Does a limited nurse triage service reduce junior doctor psychiatric on-call workload? Psych Bull 28, p368-370.
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Conflict of interest: None Declared

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