How well trained is YOUR surgeon?

Junior doctors falsify records to gain extra time in theatre as their working hours are cut
Sunday September 24, 2006
Patients are being put at risk because the number of hours' training that a doctor completes before qualifying as a consultant has fallen by around 75 per cent in the past 15 years, The Observer can reveal.Junior doctors are warning that medics hoping to become specialist surgeons say they are not spending enough time in the operating theatre to make them proficient and safe. That is because junior doctors' hours have fallen considerably under the European Working Time Directive, which means they can only work 56 hours a week, including nights on call. Their senior colleagues can work for longer.
Some surgeons have told The Observer they go voluntarily into the theatres to gain experience, then lie to their NHS trusts about the hours they work. If they reveal they have exceeded the limit, their hospital becomes liable for financial penalties from the Health and Safety Executive.
The hours of doctors in training have fallen hugely since the Eighties, when many were working between 80 and 90 hours each week. After warnings about the dangers to the public, the hours were gradually reduced to bring them more in line with a normal working week. They can now work 56 hours a week, but this will fall to 48 hours in three years' time.
In the past, a doctor would work between 30,000 and 40,000 hours before qualifying as a consultant. This has been cut to between 6,000 and 10,000, depending on the specialism.
At the same time, the government has announced plans to introduce a new training system, known as Modernising Medical Careers (MMC), that will be rolled out next August. This is supposed to allow doctors to become consultants much more quickly.
But a combination of the restriction on working hours and the MMC plans is proving disastrous, according to doctors. They say they do not have enough time on the wards or in the theatre to see all the cases they need to deal with to make them good doctors.
The other problem is that in two years, there will be 21,000 young doctors looking for jobs, but only 9,500 specialist posts. The rest will be expected to perform standard hospital work with no further specialisation.
The British Medical Association will this week call on the government to delay the plans, which it says are being rushed through. Many doctors say they plan to work abroad if they cannot find a post within the NHS.
Some have told The Observer they have to lie about the amount of surgery they do voluntarily to avoid trouble.One working in south-east England, Miriam Adebibe, said: 'It's commonplace for doctors to lie about their hours because if they stuck to their time, they simply would not get the experience they need to become good doctors.
'I don't think the public realises yet that the new generation of doctors will simply not have the expertise or the knowledge of current consultants. It is appalling that the NHS spends £250,000 training each doctor, yet isn't allowing us to do it to a high standard,' said Adebibe, who hopes to become a breast surgeon.
Both the BMA and the medical royal colleges have been warned about the falsification of records. But Dr Andrew Rowland, deputy chairman of the BMA junior doctors' committee, said: 'I can see why they may be tempted to do it, but it leaves them very vulnerable. It would be better for them to talk to their trusts and find a way of changing the rota so they do gain more experience of operating.'
A Department of Health spokesman said the new training plans would mean shorter hours but a better quality of training, because it was based on equipping doctors with the skills they would really need.