JUNIOR DOCTORS HOURS - WHAT DO THEY REALLY THINK

Junior doctors' hours are one of the most controversial topics under d ebate in the health service today. We undertook a detailed postal ques tionnaire of hospital doctors in training within a major teaching unit in order to assess the awareness and perceived implications of the in cipient changes and to elucidate how it was felt these changes would a ffect both the doctors and patients. The questionnaire focused specifi cally on the effect of the changes on quality and continuity of patien t care, junior training and socio-economic factors relating to the med ical staff. The questionnaire was entirely anonymous and carried only the first author name but provision was made to determine current grad e, speciality, age, sex and career plans of the respondents. Important ly, space was included at the end for pertinent comments. All junior s taff in training in all specialities in the Cardiff area were circulat ed. Three hundred and twenty-six questionnaires were sent out and 202 were returned of which 192 were properly completed (59%) Almost everyo ne was au fait with the proposed changes. There was a surprisingly hig h level of support for changes among non-surgical trainees, and half f elt that quality of care would improve, though the more senior the tra inee, the less enthusiastic they were in all aspects. Many felt that f ar too little consultation with junior staff had taken place and there was generalized criticism of general practitioner trainees by their s pecializing counterparts, partly because of-a perceived lack of commit ment and partly because of blame of this group for the inception of th e changes. Most importantly, there was solid opposition among surgeons in training because of a perceived reduction in patient care, comprom ise in quality of training and a belief that the system is unworkable [only 9% of registrars and senior registrars and 25% of senior house o fficers (SHOs) and housemen planning a surgical career were in favour of change]. It is clear that different specialities need to be assesse d separately. For example, the requirements for covering a partial shi ft system for special baby care, or anaesthetics are very different fr om the on call requirements of dermatology or urology. It is inappropr iate to put every speciality under the same umbrella and this should b e rethought before the introduction of the 72 h week results in unnece ssary but predictable chaos.