PREREGISTRATION HOUSE OFFICERS IN THE THAMES REGIONS - CHANGES IN QUALITY OF TRAINING AFTER 4 YEARS

Objective-To measure changes in the training and workload of preregist ration house officers over four years. Design-Postal questionnaire. Se tting-The Thames health regions. Participants-1049 preregistration hou se officers. Results-Response rate was 69% (725 replies). The proporti on of house officers officially on duty > 83 hours a week fell from at least 42% to 21%, and the proportion officially on duty less-than-or- equal-to 72 hours rose from no more than 9% to 40%. Adequate guidance in breaking bad news increased from 25% to 46% (p<0.0001; 95% confiden ce interval for difference, 16.2% to 25.8%) and guidance in pain contr ol increased from 36% to 46% (p < 0.01; 5.0% to 15.0%). The number of house officers attending an induction course increased from 61% to 94% (p < 0.001; 28.9% to 37.1%). There was no change in the proportion un able to attend formal educational sessions because of clinical commitm ents or in levels of satisfaction with consultants' educational superv ision. The median number of inpatients under house officers' care fell from 20 to 17, but the numbers of patients clerked in an average week showed little change. House officers were less satisfied with the cli nical experience their post provided (proportion dissatisfied rose fro m 30% to 39%; p<0.01; 4.2% to 13.8%) and less enthusiastic about recom mending their post to a friend (proportion neutral or not recommending rose from 30% to 42%, p < 0.0001; 7.9% to 16.9%). Conclusion-Despite progress in reducing hours of duty and providing induction courses, th e training that hospitals and consultants provide for house officers i s still unsatisfactory and inconsistent with the General Medical Counc il's recommendations.