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

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. Fifty-five logbooks were analysed across the two trusts over a two-year period, with comparisons made between pre- and post-shift working. 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. Shift working significantly impacts on surgical training opportunities. We explore approaches to minimising this effect.