ArticleIrish journal of medical science2013
The detrimental impact of the implementation of the European working time directive (EWTD) on surgical senior house officer (SHO) operative experience.
Article in Irish journal of medical science, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 2 of them syntheses that pooled it.
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Who cites it
24 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- The impact of shortening shifts of physicians during their residency on patients and physicians : A systematic review and meta-analysis.Israel journal of health policy research · 2025Pooled it
- The impact of feedback of intraoperative technical performance in surgery: a systematic review.BMJ open · 2015Pooled it
- Operative times of 7 common Orthopaedic Trauma procedures: is there a difference between trainees and consultants?Orthopedic reviews · 2025Article
- Impact of work hour restrictions on the operative experience of general surgical residents: A systematic review.Surgery in practice and science · 2023Review
- Attitudes and access of Irish general surgery trainees to robotic surgical training.Surgery open science · 2022Article
- The FAST Workstation Shows Construct Validity and Participant Endorsement.Arthroscopy, sports medicine, and rehabilitation · 2021Article
- Supporting laparoscopic general surgery training with digital technology: The United Kingdom and Ireland paradigm.BMC surgery · 2021Review
- Less is more: creation and validation of a novel, affordable suturing simulator for anorectal surgery.Techniques in coloproctology · 2019Article
- Satisfaction of the Irish Trauma and Orthopaedic training programme with the Intercollegiate Surgical Curriculum Programme.Irish journal of medical science · 2019Article
- Force-based learning curve tracking in fundamental laparoscopic skills training.Surgical endoscopy · 2018Article
- The Urology Residency Program in Israel-Results of a Residents Survey and Insights for the Future.Rambam Maimonides medical journal · 2017Article
- Surgical learning activities for house officers: do they improve the surgical experience?Irish journal of medical science · 2016Article
- Homemade laparoscopic surgical simulator: a cost-effective solution to the challenge of acquiring laparoscopic skills?Irish journal of medical science · 2016Article
- The Importance of Fostering Ownership During Medical Training.The American journal of bioethics : AJOB · 2016Review
- An analysis of medical students' attitude to surgical careers and pursuing intercalated research degrees.Irish journal of medical science · 2016Article
- A prospective audit of emergency urology activity in a university teaching hospital.Irish journal of medical science · 2015Article
- Other consequences of reduced duty hours. The authors respond.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2015Article
- "Is general surgery still relevant to the subspecialised trainee?" A 10 year comparison of general versus specialty surgical practice.World journal of surgery · 2015Article
- Laparoscopy training in Belgium: results from a nationwide survey, in urology, gynecology, and general surgery residents.Advances in medical education and practice · 2015Article
- A EWTD Compliant Rotation Schedule Which Protects Elective Training Opportunities Is Safe and Provides Sufficient Exposure to Emergency General Surgery: A Prospective Study.Surgery research and practice · 2015Article
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundConcerns have been voiced regarding the impact of the European Working Time Directive (EWTD) on surgical training. Following its introduction (August 2009) in Wexford General Hospital, Ireland Surgical Senior House Officers (SSHOs) are required to leave the hospital at 10 a.m. the morning after on-call duty. This study investigates the consequences of this practice on operative experience gained by six SSHOs in comparison to their predecessors.
methodsA prospectively maintained database of surgical procedures was interrogated. Operative experience of SSHOs over a 5-month period (August-December 2009) was compared with that of colleagues 1 year earlier. The primary endpoint was overall operative volume of SSHOs. Subgroup analysis was performed of cases by primary operator versus assistant, intermediate versus minor procedures and by team. Comparison was made of operative volume between Group 1 (pre-EWTD) and Group 2 (post-EWTD).
resultsOperative volume for Group 1 (pre-EWTD) was 461 cases. Group 2 (post-EWTD) was involved in a total of 349 operations, showing a decrease of 24% (P=0.006). SSHOs in Group 1 (pre-EWTD) had been the primary operator in 109 cases compared to 87 in Group 2 (post-EWTD), demonstrating a reduction of 20% (P=0.06). Most worryingly, there was a reduction of 63% (P=0.04) in the intermediate cases performed as operating surgeon in Group 2 (post-EWTD).
conclusionsThe present data set demonstrates a significant reduction in operative experience gained by SSHOs after local implementation of the EWTD. A major challenge facing Irish surgical training over the next decade is reduced operative exposure in the clinical setting.
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Registered trials
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