Current neurosurgical trainees' perception of the European Working Time Directive and shift work

Area of Science:

• Neurosurgery
• Medical Education
• Healthcare Policy

Background:

• The European Working Time Directive (EWTD) mandated changes to working hours for medical professionals.
• The implementation of shift systems in UK neurosurgical units aimed to comply with EWTD.
• This shift system has significantly altered the operational landscape of neurosurgical care.

Purpose of the Study:

• To assess current out-of-hours cover provisions in UK neurosurgical units.
• To evaluate the impact of the shift system on patient safety, registrar training, and work-life balance.
• To compare the traditional 24-hour on-call system with the newer shift system.

Main Methods:

• A telephone survey was conducted with on-call registrars from all 33 UK neurosurgical units.
• Data were collected on emergency provisions and registrar experiences under both on-call and shift systems.
• Registrars with experience in both systems provided comparative feedback.

Main Results:

• Twenty-two units (66.7%) still operate traditional 24-hour on-call systems.
• Of registrars who experienced both systems, 95.45% believed traditional on-calls offered better clinical exposure and patient care.
• 86.36% considered on-calls safer, while 59.09% reported increased fatigue with shift work.

Conclusions:

• Neurosurgery registrars perceive the shift system as detrimental to patient safety, training, and work-life balance.
• A significant number of units may be misrepresenting their on-call arrangements to comply with EWTD.
• The study highlights concerns regarding the effectiveness and true implementation of the EWTD in UK neurosurgical training and practice.