The modernisation of the surgical house officer

INTRODUCTION: There have been considerable changes in the junior doctors' hours and working patterns over the last 4 years. The aim of this study was to assess the effect of these changes on the house officers' surgical experience and to obtain their opinions on the 'Hospital at Night' system, which has recently been introduced at our large teaching hospital. METHODS: A questionnaire was filled out by surgical house officers at the end of their surgical posts in 2001. The same questionnaire was then repeated for house officers completing the same posts in 2005. RESULTS: Pre-registration house officers now see less acute surgical admissions (mean 5 patients in 3 months in 2005 compared with 35 in 2001; P < 0.0001) and spend less time attending theatre than four years ago (mean 12 sessions in 3 months in 2001 compared with 6 in 2005). Despite the reduction in hours, they are still managing to attend educational sessions. Nine out of ten house officers felt that the 'Hospital at Night' system was unsatisfactory. They were unable to see and clerk acute surgical admissions or go to theatre because they were providing cross cover for other specialties. CONCLUSIONS: The full shift system and the introduction of the 'Hospital at Night' team have led to a reduction in acute surgical experience for surgical house officers. The General Medical Council recommendations for reducing non-educational tasks have not been fulfilled despite the evolving role of nurse practitioners.