Shift working reduces operative experience for trauma and orthopaedic higher surgical trainees: a UK multicentre study

INTRODUCTION: In recent years there has been a rise in the number of trauma and orthopaedics trainees working on full shift patterns. Historically, most trauma and orthopaedics trainees worked 24 hours non-resident on-call shifts. The effect of this change in shift patterns has not previously been measured. As two trusts (one trauma unit, one major trauma centre) in our region underwent a change to full shift working, we assessed the impact on the trainees' operating experience.

METHODS: Fifty-five logbooks were analysed across the two trusts over a two-year period, with comparisons made between pre- and post-shift working.

RESULTS: Overall operating fell by 13% for trainees working full shift patterns, which was statistically significant. There was a loss of elective operating of 15% at the trauma unit and 32% at the major trauma centre for trainees doing shift work. The effect on trauma operating opportunities was mixed. Index operating was largely preserved.

CONCLUSIONS: Shift working significantly impacts on surgical training opportunities. We explore approaches to minimising this effect.