THE IMPACT OF THE EUROPEAN WORKING TIME REGULATIONS AND MODERNISING MEDICAL CAREERS ON OUT-OF-HOURS ENT COVER

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Abstract

The implementation of the European Working Time Regulations (EWTR), coupled with the ongoing impact of Modernising Medical Careers (MMC), has necessitated a significant redevelopment of out-of-hours cover for surgical specialties in the UK. A review of the literature related to the provision of out-of-hours ENT cover gives an insight into the impact of these changes on a comparatively small surgical specialty. A 2008 survey revealed that three-quarters of junior doctors providing ENT out-of-hours care were cross-covering specialties other than ENT1- a figure up from just over half of junior doctors in 2005, prior to stricter EWTR rules.2Of all ‘first-on-call’ doctors for ENT, only 19-32% have prior ENT experience.1,3,4Consequently, ENT services are provided frequently by inexperienced, non-ENT doctors covering multiple other specialties, often as part of a ‘hospital-at-night’ team.5

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