Junior doctors' learning has 'suffered'
Junior doctors' learning suffers because of service reorganisation says report
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Thursday, 06, Aug 2009 09:37
The training of junior doctors is being affected by service reorganisation, with learning opportunities suffering, a report has said.
A study from the Royal Liverpool University hospital, one of the government's pilot hospitals, has found new systems trialled for assessing and reviewing patients may have a negative effect on the training of junior doctors.
Published in the journal Clinical Medicine this week, the findings describe how NHS targets are being met, but "trainees' learning opportunities have suffered".
The reforms helped waiting times, but the restriction of hours prevented junior doctors from being present when the patients they admitted to the wards were reviewed by a consultant. The authors said: "At this stage around half of all diagnoses are changed and the current system has no mechanism for feedback to the initial assessing team."
Dr Solomon Almond, a member of the research team, said: "The results of our audit highlight the benefits for patients of being seen by consultants soon after admission. However, the restriction of junior doctors' hours means there is less time for consultants to discuss their decisions with the doctors in training.
"Ideally all emergency admissions would be seen straight away by consultants accompanied by the junior doctors. This would re-establish the link between hands-on clinical medicine, training and experience that was for many years the foundation of post graduate medical education in this country."
It was announced earlier this week the hours which junior doctors worked would be reduced to 49 a week, to comply with EU regulations.
The researchers said the patterns of work and systems employed at the Royal Liverpool that they studied are likely to be found in other hospitals struggling to balance government targets for waiting times with the new target for reducing junior doctors' working hours.
A spokesperson for the Department of Health told inthenews.co.uk: "The quality of training and supervision is more important than the quantity of hours completed. We know that junior doctors are concerned about their training and that is why the secretary of state has asked Medical Education England to review the quality of training in the light of the directive.
"Doctors also now have the chance to learn many of the skills they need on a range of hi-tech simulators where they have the opportunity to rehearse the procedures and the management of rare or serious clinical events in a way that does not put real patients at risk if errors are made.
"Targets have undoubtedly improved the experience of the majority of patients who visit A&E, with 98 per cent of patients now receiving treatment within four hours of arrival."