title: Out-of-hours work in cardiothoracic surgery: implications of the New Deal and Calman for training.
abstract: 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'.
authors.affiliation: Department of Cardiothoracic Surgery, Northern General Hospital NHS Trust, Sheffield, UK.
authors.forename: C
authors.initials: C
authors.lastname: Kelty
authors.forename: J
authors.initials: J
authors.lastname: Duffy
authors.forename: G
authors.initials: G
authors.lastname: Cooper
mesh_terms: D004503:Education, Medical, Graduate / Q000379:methods*; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D006801:Humans; D007318:Inservice Training; D010561:Personnel Staffing and Scheduling; D013903:Thoracic Surgery / Q000193:education / Q000706:statistics & numerical data*