title: The effect of a full shift system on doctors.
abstract: OBJECTIVE
  This paper aims to investigate the implications and impact from the implementation of European Working Time Directive (EWTD) compliant working patterns (the introduction of shifts) on doctors.
  
  
  METHODS
  A qualitative, case study based research method was used. Data collection involved: the application of semi-structured, open-ended interviewing to elicit information based upon categories defined from the literature survey; follow-up conversations with many interviewees; participant observation; thematic coding and analysis of the results.
  
  
  RESULTS
  Shifts are here to stay. All doctors interviewed acknowledged that, but there was a general feeling of minimal flexibility in the system. A recurrent theme when asked how things could be improved was to split-up the week of night shifts into two shorter periods. Some doctors, particularly those working full-time with small children, already split their weekends in order to spend time with their family.
  
  
  CONCLUSIONS
  The methodology applied was appropriate, generating ample data to facilitate discussion and from which to draw specific conclusions. A perceived limitation is the single case approach; however Remenyi argues this can be enough to add to the body of knowledge. Practical implications - The research generated suggestions for how shifts could be scheduled to make them more palatable for those who work them. Specific recommendations for future research are made.
  
  
  CONCLUSIONS
  The research questions of the paper draw out the personal implications for doctors of their employers' adherence to the implementation of EWTD.
authors.affiliation: St James University Hospital, Leeds, UK.
authors.forename: Nicola
authors.initials: N
authors.lastname: Bamford
authors.forename: David
authors.initials: D
authors.lastname: Bamford
mesh_terms: D006801:Humans; D007407:Interviews as Topic; D010820:Physicians; D013222:State Medicine; D006113:United Kingdom; D014940:Work Schedule Tolerance