title: European Working Time Directive: Implementation across -Europe and consequences upon training in obstetrics and -gynaecology.
abstract: OBJECTIVE
  To review the compliance of the European Working Time Directive (EWTD) in different teaching hospitals across Europe and its consequences upon training.
  
  
  METHODS
  It is an observational, descriptive, cross-sectional study. The sample is constituted by the answers from trainees selected by the representatives of 29 European Network of Trainees in Ob/Gyn (ENTOG) member countries to a survey designed by ENTOG Executive. The survey content was based on a joint survey by the Royal College of Obstetricians and Gynaecologists (RCOG) and the Royal College for Paediatrics (RCP), carried out in 2008, but adapted for use on a European level.
  
  
  RESULTS
  An answer rate of 75% was obtained. Only 5 countries out of 29 were compliant with EWTD two months before the compulsory adherence. Countries needed to introduce 1 to 4 changes to the system to make the rotas -compliant. Positive effect on work and private life balance was noticed in 87% from all responses. Trainees notice the need to further improve training programmes in order to have the same quality of training and continuous care of patients.
  
  
  CONCLUSIONS
  Steps forward to implement EWTD are being made. Trainees should be involved with the introduction to optimize training conditions under the EWTD. Countries that still struggle to introduce the directive may learn from countries that already are compliant. It is suggested to organize a survey on senior society level to gain additional information to further investigate the effects on training quality and patient care.
authors.affiliation: Department of Obstetrics and Gynaecology. East Tallinn Central Hospital, Tallinn, Estonia.
authors.forename: P
authors.initials: P
authors.lastname: Pärgmäe
authors.affiliation: Department of Obstetrics and Gynaecology. Hospital de São Teotónio, Viseu, Portugal.
authors.forename: N
authors.initials: N
authors.lastname: Martins
authors.affiliation: Department of Obstetrics and Gynaecology. Hospital Sant Joan de Deu, Barcelona, Spain.
authors.forename: D
authors.initials: D
authors.lastname: Rodríguez
authors.affiliation: Second Department of Obstetrics and Gynaecology. Athens University Medical School, Athens, Greece.
authors.forename: P
authors.initials: P
authors.lastname: Christopoulos
authors.affiliation: Obstetrics and Gynaecology Department, Haukeland University Hospital, Bergen, Norway.
authors.forename: H M J
authors.initials: HM
authors.lastname: Werner
keywords: ENTOG; Europe; European Working Time Directive; survey; trainees