Training and the European Working Time Directive: a 7 year review of paediatric anaesthetic trainee caseload data.
BACKGROUND
The implementation of the European Working Time Directive (WTD) has reduced the hours worked by trainees in the UK to a maximum of 56 h per week. With a further and final reduction to 48 h per week scheduled for August 2009, there is concern amongst doctors about the impact on training and on patient care. Paediatric anaesthesia is one of the specialist areas of anaesthesia for which the Royal College of Anaesthetists (RCoA) recommends a minimum caseload during the period of advanced training.


METHODS
We conducted a retrospective analysis of theatre logbook data from 62 Specialist Registrars (SpRs) who had completed a 12 month period of advanced training in paediatric anaesthesia in our institution between 2000 and 2007.


RESULTS
After the implementation of the WTD 56 h week in 2004, the mean total number of cases performed by SpRs per year decreased from 441 to 336, a 24% reduction. We found a statistically significant reduction across all age groups with the largest reduction in the under 1 month of age group. The post-WTD group did not meet the RCoA recommended total minimum caseload or the minimum number of cases of <1 yr of age.


CONCLUSIONS
Since the implementation of the WTD, there has been a significant reduction in the number of cases performed by SpRs in paediatric anaesthesia and they are no longer achieving the RCoA recommended minimum numbers for advanced training.
Fernandez
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Anaesthetic Department, Great Ormond Street Hospital, Great Ormond Street, London WC1N 3JH, UK.
Williams
D G
DG
D000776:Anesthesiology / Q000193:education*; D002648:Child; D002675:Child, Preschool; D004503:Education, Medical, Graduate / Q000458:organization & administration*; D005062:European Union; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008131:London; D008505:Medical Staff, Hospital / Q000193:education / Q000331:legislation & jurisprudence / Q000458:organization & administration; D010372:Pediatrics / Q000193:education*; D010561:Personnel Staffing and Scheduling / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D012189:Retrospective Studies; D016526:Workload / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data