Senior house officers in medicine: postal survey of training and work experience

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Abstract
Objectives: To describe working conditions for senior house officers in medicine in Scotland and to relate these to the quality of clinical training they receive. Design: Postal questionnaire survey. Subjects: All senior house officers in medicine and related specialties in post in Scotland in October 1995 (n=437); 252 (58%) respondents. Main outcome measures: Questionnaires covered hours, working patterns, measures of workload, an attitudes to work scale, and experience of education and training. Results: In the week before the questionnaire, doctors on rotas had worked a mean of 7.4 (95% confidence interval 5.8 to 9.0) hours in excess of their contracts, compared with 3.7 (2.0 to 5.5) hours for those on partial shifts. The most common reason for this was “the needs of the patients or the service.” Those on partial shifts reported significantly less continuity of care with patients than those on rotas (Mann-Whitney U test, z=-4.2, PConclusions: The quality of senior house officers' training is detrimentally affected by a variety of conditions, especially the need for closer support and supervision, the need for greater feedback, and the lack of time that consultants have to dedicate to clinical training. Efforts should be made to improve these conditions and to reinforce a close working relationship between trainee and supervising consultant. Many senior house officers continue to work long hours in excess of their contracts Senior house officers see partial shifts as detrimental to their own health, patient care, and clinical training Acute general medicine has a higher intensity of work than the allied specialties The quality of consultant feedback has an important influence on perception of learning, ability to cope, and relationships between junior and senior staff

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