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

Abstract

Objective. The European Working Time Regulations (EWTR) have been criticised 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 hour 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 minutes, 25.9%, versus 214/636 minutes, 33.6%) and a greater proportion on education (195/613 minutes, 31.8%, versus 139/636 minutes, 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 minutes, 29.9%, versus 126/804, 15.7% minutes). On night shift, medical interns spent a significantly greater proportion of the shift on direct care (590/720 minutes, 81.9%, versus 346/727 minutes, 47.6%) and education (33/720 minutes, 4.6%, versus 6/727 minutes, 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.