naa a22 4500 510740529 CHVBK 20180411083026.0 cr unu---uuuuu 180411e20130901xx s 000 0 eng 10.1007/s11845-012-0894-6 doi (NATIONALLICENCE)springer-10.1007/s11845-012-0894-6 The detrimental impact of the implementation of the European working time directive (EWTD) on surgical senior house officer (SHO) operative experience [Elektronische Daten] [K. Breen, A. Hogan, K. Mealy] Background: Concerns have been voiced regarding the impact of the European Working Time Directive (EWTD) on surgical training. Following its introduction (August 2009) in Wexford General Hospital, Ireland Surgical Senior House Officers (SSHOs) are required to leave the hospital at 10a.m. the morning after on-call duty. This study investigates the consequences of this practice on operative experience gained by six SSHOs in comparison to their predecessors. Methods: A prospectively maintained database of surgical procedures was interrogated. Operative experience of SSHOs over a 5-month period (August-December 2009) was compared with that of colleagues 1year earlier. The primary endpoint was overall operative volume of SSHOs. Subgroup analysis was performed of cases by primary operator versus assistant, intermediate versus minor procedures and by team. Comparison was made of operative volume between Group 1 (pre-EWTD) and Group 2 (post-EWTD). Results: Operative volume for Group 1 (pre-EWTD) was 461 cases. Group 2 (post-EWTD) was involved in a total of 349 operations, showing a decrease of 24% (P=0.006). SSHOs in Group 1 (pre-EWTD) had been the primary operator in 109 cases compared to 87 in Group 2 (post-EWTD), demonstrating a reduction of 20% (P=0.06). Most worryingly, there was a reduction of 63% (P=0.04) in the intermediate cases performed as operating surgeon in Group 2 (post-EWTD). Conclusions: The present data set demonstrates a significant reduction in operative experience gained by SSHOs after local implementation of the EWTD. A major challenge facing Irish surgical training over the next decade is reduced operative exposure in the clinical setting. Royal Academy of Medicine in Ireland, 2013 European working time directive, EWTD nationallicence Surgical training nationallicence Senior house officer, SHO nationallicence Breen K. Department of Surgery, Wexford General Hospital, Wexford, Ireland aut Hogan A. Department of Surgery, Wexford General Hospital, Wexford, Ireland aut Mealy K. Department of Surgery, Wexford General Hospital, Wexford, Ireland aut Irish Journal of Medical Science Springer-Verlag 182/3(2013-09-01), 383-387 0021-1265 182:3<383 2013 182 11845 https://doi.org/10.1007/s11845-012-0894-6 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s11845-012-0894-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Breen K. Department of Surgery, Wexford General Hospital, Wexford, Ireland aut NATIONALLICENCE 700 1- Hogan A. Department of Surgery, Wexford General Hospital, Wexford, Ireland aut NATIONALLICENCE 700 1- Mealy K. Department of Surgery, Wexford General Hospital, Wexford, Ireland aut NATIONALLICENCE 773 0- Irish Journal of Medical Science Springer-Verlag 182/3(2013-09-01), 383-387 0021-1265 182:3<383 2013 182 11845 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer