Shift working reduces operative experience for trauma and orthopaedic higher surgical trainees: a UK multicentre study

Abstract

Introduction In recent years there has been a rise in the number of trauma and orthopaedics trainees working on full shift patterns. Historically, most trauma and orthopaedics trainees worked 24 hours non-resident on-call shifts. The effect of this change in shift patterns has not previously been measured. As two trusts (one trauma unit, one major trauma centre) in our region underwent a change to full shift working, we assessed the impact on the trainees’ operating experience. Methods Fifty-five logbooks were analysed across the two trusts over a two-year period, with comparisons made between pre- and post-shift working. Results Overall operating fell by 13% for trainees working full shift patterns, which was statistically significant. There was a loss of elective operating of 15% at the trauma unit and 32% at the major trauma centre for trainees doing shift work. The effect on trauma operating opportunities was mixed. Index operating was largely preserved. Conclusions Shift working significantly impacts on surgical training opportunities. We explore approaches to minimising this effect.

Women in trauma and orthopaedics: are we losing them at the first hurdle?

“…Lifestyle factorsFactors related to lack of work-life balance were the most frequent deterrents among women who opted against a career in orthopaedics. The implementation of the European Working Time Directive (EWTD) in the UK led to a change in 24-hour nonresident on-calls to a 12-hour on-site resident shift pattern, with trainees working more frequent on-calls resulting in mismatched trainee and trainer working patterns(13).Women undertaking their clinical placement in T&O are likely to be exposed to trainees frequently undertaking on-call duties or those attending operating lists on their free days to complement their training needs, which may negatively impact students' perception of the work-life balance of the speciality(14).To improve the recruitment of women in orthopaedic training, work patterns should be designed to offer more flexibility whilst considering the welfare of the trainees as well as their training needs. The misperception regarding the lack of work-life balance in T&O could be dispersed by increasing students' exposure to role models in T&O who are women.…”