Current Surgical Senior House Officers in the UK Perform Only One Quarter of Emergency Open Appendicectomies

Current surgical Senior House Officers (SHOs) work roughly half the number of hours of their predecessors, who were trained before implementation of the European Working Time Directive (EWTD). Whilst this may result in less tired trainees and potentially better patient care, is there a detrimental impact to SHO experience and training? The case notes of 100 consecutive open appendicectomies from the years 1996/7 and 2003/4 were retrieved. Data was recorded concerning the presence of the surgical SHO at the operation and whether they had performed the surgery. Ninty four percent of case notes were retrieved. These showed that in 1996/7 surgical SHOs performed an average of 51% of all open emergency appendicectomies and were present at 63%. In 2003/4 the surgical SHO was the primary surgeon at 25% of all open appendicectomies and was present at only 40%. Since implementation of the EWTD the number of appendicectomies being performed by SHOs has halved. If surgical SHO trainees are being denied the opportunity of performing basic emergency surgical operations then they will enter their specialist registrar period still requiring training in basic emergency surgical procedures and consequently further reducing opportunities for the more advanced training, that is required to become a consultant.