The European Working Time Directive and the effects on training of surgical specialists (doctors in training): a position paper of the surgical disciplines of the countries of the EU.
Legislation launched with the EWTD was born as a "Protection of the clinical personnel against overwork for the benefit of Patients" (consumer protection and safety). It appeared that this legislation is in direct and severe conflict with former EU legislation to train competent surgical specialists. First experiences with the EWTD show far reaching and serious consequences on the training of surgical specialists as well as on medical care. There will be a reduction of about 30-35% of clinical and operative experience acquired during the usual 6 yrs of training, with many other negative aspects (see p. 7). All measures proposed so far to overcome the ensuing problems are unworkable. The training of competent surgical specialists as required by the Directive 93/16 EEC is no longer possible and serious problems with safe patient care will occur in the short term, if no political actions are taken. The surgical specialties, represented in the UEMS, provide a proposal for a working hour model consisting of 48 hrs working time (incl. service duties) plus additional 12 hrs reserved and protected for teaching and training. This model would adhere to the EWTD on the one hand, yet maintain the desired standard of training. This proposed exemption from the EWTD would be limited to the time of specialist training. We ask the responsible politicians to find a solution rapidly to prevent serious negative consequences. This motion is supported by the surgical specialties (neurosurgery, general surgery, orthopaedic surgery, paediatric surgery, cardio-thoracic surgery, vascular surgery, oto-rhino-laryngology, list not complete) of the member states of the EU, representing more than 80,000 surgical specialists.
Benes
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Department of Neurosurgery, UVN Stresovice, U nemocnice, Prague, Czech Republic. vladimir.benes@uvn.cz
D000046:Academic Medical Centers / Q000331:legislation & jurisprudence; D002983:Clinical Competence; D016265:Conflict of Interest; D004503:Education, Medical, Graduate / Q000331:legislation & jurisprudence*; D005060:Europe; D005062:European Union; D006801:Humans; D007396:Internship and Residency / Q000331:legislation & jurisprudence*; D017145:Models, Educational; D010561:Personnel Staffing and Scheduling / Q000331:legislation & jurisprudence; D011787:Quality of Health Care / Q000331:legislation & jurisprudence; D017751:Safety Management / Q000331:legislation & jurisprudence; D012955:Societies, Medical; D013043:Specialties, Surgical / Q000193:education* / Q000331:legislation & jurisprudence; D013997:Time Factors; D014940:Work Schedule Tolerance; D000078329:Workforce; D016526:Workload / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data