EWTD & the 48 hour myth

Apparently, the solution to the problems caused by the EWTD is to encourage junior doctors to “complete training projects outside of their normal working hours”  I’m still formulating a sensible thought process to this, but it comes back to “what do they think we do now??”

It’s taken me a while to respond to this suggestion that junior doctors should “do a bit extra” in their spare time because I’ve been busy. (I know: I can see the irony here).  I know I’m the academic trainee and so a lot of my “spare time” work is self-inflicted so I’ve tried not to go off my own experiences here.

We don’t accurately measure or record how much work junior doctors currently do in their assigned working day, never mind outside of those hours.  Working hours are monitored, but what happens to that data? The response to a breach in working pattern is to repeat the monitoring exercise, or to investigate the junior to make sure that they are telling the truth. (I love how nobody ever suggests investigating a monitoring report where I leave work precisely on time and have a 30 minute uninterrupted break every day for a fortnight. Because that’s such a realistic situation).  And, well, by the time it’s been repeated, it’s time for a new cohort to start…

Yesterday, as I went home, three SHOs sat in the office ploughing through old notes for an audit. It ‘has’ to get done, and there’s no time to do it during the day.  I’ve had a chat with some (non-academic) colleagues recently, and as a bare minimum, these are the things that they do in their “spare time”.

  1. Exam preparation
  2. Clinic attendance
  3. Audit
  4. Preparing teaching sessions
  5. Attending mandatory courses

None of this will get counted in the EWTD hours; none of it is recognised or acknowledged.  Because if it was counted, then we would have to realise that junior doctors already work well in excess of the 48 hour average.  And that is the bare minimum: that doesn’t count those of us with special interests; attending conferences; going to meetings; developing resources…

Confining us to a 48 hour week has implications for training & patient care.  But to refuse to acknowledge the huge amount of work & time that trainees already put in outside of working hours seems a little unrealistic.  It’s not a 48 hour week, and we need to be honest about that.

Because I can always fit another project into my “spare time”…

Sure. Why not? Sleep is over-rated anyway


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