All doctors in training must spend at least half of their working time (over a 24-hour period) during periods when consultants are rostered to be on site. If consultants have programmed activities on the Intensive Care Unit at other than usual office hours, these times may be counted towards the doctor in training’s normal daytime hours, as direct consultant supervision is the deciding factor.
It is important that a minimum proportionate degree of training time is spent at night and weekends since the nature of experience at night is qualitatively different from that during the day. Working overnight and during weekends should therefore constitute a minimum of approximately 1/8 of rostered clinical time.
It is accepted that there will be a need, particularly in smaller intensive care units, for the first line of call at night to be drawn from a pool of resident doctors comprised of doctors in training and, not all of whom may be attached to intensive care during the day. Local arrangements must be made in these circumstances to ensure that appropriate induction and lines of reporting are in place, that the cover is provided by those with adequate competencies and that an appropriate skill mix is always available. Within the limits of the EWTD there is no requirement for a working day to be of any particular duration.
As stated in Training Standards above, regular signposted educational activity directed to learners’ needs should be provided. And when timetabled, doctors in training should be expected to attend such organised teaching and not be scheduled to be present on the intensive care unit, so long as it forms part of a work programme compatible with EWTD and the relevant junior doctor contract.
