Impact of working 48 h per week on opportunities for training and patient contact: The experience of Irish interns

Abstract

Objective: The European Working Time Regulations (EWTR) have been criticized for its purported negative impact on the training of junior doctors. The aim of this study was to examine the amount of time interns spent engaging in various work activities. Design: An online time-use diary was used to collect data from interns. Setting: Two teaching hospitals in the Republic of Ireland. Participants: A total of 45 interns logged at least one 24-h period. The logs were obtained from 67 shifts from a surgical rotation and 83 shifts from a medical rotation. Main Outcome Measures: The amount of time interns spent engaging in direct patient care, indirect patient care, educational activities and personal activities. Results: On day shift, medical interns spent a significantly smaller proportion of the shift on direct care (159/613 min, 25.9% versus 214/636 min, 33.6%) and a greater proportion on education (195/613 min, 31.8% versus 139/636 min, 21.9%) than surgical interns. On extended days, medical interns spent a significantly larger proportion of the shift on education than surgical interns (243/ 814 min, 29.9% versus 126/804, 15.7% min). On night shift, medical interns spent a significantly greater proportion of the shift on direct care (590/720 min, 81.9% versus 346/727 min, 47.6%) and education (33/720 min, 4.6% versus 6/727 min, 0.8%) than surgical interns. Conclusions: The interns in the study reported spending more time on direct patient care and educational activities, and less time on indirect patient care activities than interns in other countries.