MAM event - as reported in "The Times" - 27/8/2010

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Saturday, 28th August 2010

Doctors in training work 80 hours a week – study
'Doctors' work abroad should only be for experience'
Nikki Abela Mercieca

Doctors in training spend about 80 hours at work per week, with half of them sometimes clocking up over 30 hours at a stretch, a survey has revealed.

“There is too much work in hospital. It is too tiring. If I make a mistake here, the responsibility is enormous,” a surgical specialty trainee said yesterday.

The survey was conducted by the Medical Association of Malta and presented at a seminar for junior doctors yesterday. The seminar was closed to the media on a decision taken by the association.

However, delegates revealed the contents of the presentation given to the large audience, which included Health Minister Joe Cassar.

The Foundation Programme, launched just over a year ago for newly-graduated doctors, sees about 92 per cent of the young doctors staying on after a 24-hour “duty”, to add up about 80 hours per week, according to the survey.

The surgical specialty was said to have it worst, with doctors working up to 100 hours per week.

Moreover, the study found that senior house officers in the medical speciality felt understaffed during duties.

Speaking to The Times about doctors’ long hours, the event’s guest speaker Shree Datta said: “There needs to be a balance between what is safe for individual doctors and what is safe for patients.”

Dr Datta, who chairs the British Medical Association’s Junior Doctors Committee, said the National Health Service in the UK came across problems implementing the European Working Time Directive in hospitals last year as the stipulated maximum of 48 hours’ work per week was hard to achieve given their present workforce, a problem that would be echoed in a small country like Malta.

At the moment, Dr Datta said, the UK was not self-sufficient when it came to doctors and this was why many were being recruited from EU and non-EU countries. She highlighted the importance for small countries to retain the doctors they were training due to each country’s large investment in them.

Regarding the medical brain-drain, the survey found that over 75 per cent of trainees would consider working abroad but the same number wanted to return after. Surprisingly, many doctors preferred to go abroad for only part of the programme.

“The pathology that you find in other countries is very different to what trainees are exposed to in a smaller hospital and there is a role for doctors to experience work abroad. But only to experience it,” Dr Datta said.

The study also touched upon training for doctors, which had been set up in the last few years to curb the brain-drain. It showed a large discrepancy between training in the different specialities, especially with the amount of “protected time” allowed for focused training, with anaesthesia, radio­logy and family medicine seeming to have it best.

“I have nothing to complain about,” an anaesthesia trainee said, adding that training was well structured and presented many learning opportunities.

Two specialties, surgery and obstetrics and gynaecology, showed a decreased satisfactory rate among trainees. While the first specialty appointed two new coordinators to manage the system better, the other saw three trainees leaving the programme to join other courses, with only one new doctor joining the course this year.

Half of the foundation programme trainees complained they did not receive adequate feedback from supervisors and were interrupted by ward calls during lectures. The last two issues are already being addressed by the union and the programme.

Speaking at the seminar, Dr Cassar reiterated his commitment to retain doctors in Malta and guarantee the quality of future specialists. “It is in the common interest of both the medical profession and the patients we serve to strive for high standards in the delivery of post-graduate training,” he said.

Dr Cassar said that some areas had been identified as requiring attention and a committee had been set up to address them.

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