Recent changes in the workload and clinical experience of pre-registrationhouse officers: experiences over four years in south-west England

We aimed to measure changes in the training and workload of pre-registratio n house officers using a postal questionnaire. Two hundred and six pre-regi stration house officers in the south-western region of England were surveye d and asked to report on the education, training and workload of their post s. Results were compared with a survey conducted four years earlier. Since the previous survey, the number of hours on duty had reduced from a median of 80 h week(-1) in 1992/3 to 72 h week(-1) in 1996/7 (P < 0.0001). There w ere no statistically significant changes in the number of patients admitted or clerked in an average week, but house officers' clinical experience had fallen. All but five of 26 marker conditions showed a decline, which was s tatistically significant in seven cases. House officers were keener to incl ude four months of general practice in the pre-registration year and were l ess adverse to extending the pre-registration year to two years. The reduct ion in hours of work for house officers has been accompanied by a decline i n their clinical exposure to common medical and surgical emergencies. The l ong-term effects of these changes are unknown.