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Training of senior house officers

Queen’s Medical Centre, Nottingham

In their recent paper Callaghan et al (Psychiatric Bulletin, February 2005, 29, 59-61) showed that senior house officers (SHOs) in psychiatry usually valued on-call periods as a learning experience. However, the European Working Time Directive regulations regarding hours worked and rest requirements are now well and truly upon us and this has caused concern regarding the training of SHOs in other specialties (Mayor, 2005).

In Nottingham, SHOs in psychiatry previously worked a high intensity shift pattern that did not adhere to European Working Time Directive regulations. Measures implemented to ensure adherence to the new regulations included the appointment of psychiatric nurses to work specifically at night as the first point of call for anyone referring to the psychiatric SHO. Initially SHOs were involved with the majority of the assessments but over time the nursing team’s experience has increased and they are now proficient in managing almost all of the referrals independently. As a consequence, SHOs are now finding that their participation in acute decision-making, risk assessment and devising management plans has reduced significantly.

The movement of specialist nurses into the role traditionally fulfilled by SHOs should not act as a barrier to training. Additional measures need to be introduced to ensure SHOs remain exposed to acute psychiatric cases. Possibilities include nursing teams providing direct training and a more comprehensive trainee’s logbook where emergency cases seen are recorded. This would also be a step towards workplace assessment for doctors in training which is emphasised in Modernising Medical Careers (Department of Health, 2002).

References

DEPARTMENT OF HEALTH (2002) Unfinished Business Proposals for Reform of Senior House Officer Grade. A Paper for Consultation. London: Department of Health.

MAYOR, S. (2005) UK surgeons report that EU directive has cut training time. BMJ, 330, 499.[Free Full Text]

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