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Tuesday, 4 May, 1999, 15:52 GMT 16:52 UK
Junior doctors fight exhaustion
Dr Seymour is on call from 5am
Junior doctors' workload varies according to where they work, but some can be on duty for 36 hours or more at a stretch.

According to a deal struck in 1991, they should not work more than 56 hours a week or be on call more than 72 hours a week.

But the British Medical Association says at least a third are still putting in longer hours.

Dr Ian Wilson is deputy chairman of the BMA's Junior Doctors Committee annual conference.

He says patients are undoubtedly put at risk when doctors have to work excessively long hours.

"I have have made mistakes that have turned out not to be serious," he said.

"But I think I have been lucky. It is only a small step from making a minor error to making a major mistake.

"Part of you goes on to auto pilot, part of you just deals with it, and another part starts to blame patients for being sick.

"Somebody estimated that the end of a long shift can have the same impact on mental performance as drinking three or four pints of beer.

"I have been so tired that I have sat down to write some notes, fallen asleep and wooken up to find my pen dragging across the page.

"There were also times when I have not been able to be nice to people."

Three hours sleep a night

Dr Hannah Seymour, a doctor at the Western General Hospital in Edinburgh, says she can be on call from 5am on one day until 9am the following day for acute medical admissions.

She says she gets around three or four hours sleep in a night.

"You get very fed up and tired," she said. "The nurses notice, but we try to take care that it does not reflect on the patient."

Dr Seymour, who has decided to move to Australia, says she has to think about her work more carefully when she is tired which means she takes longer to perform tasks.

She calculates that she is on call an average of 64 hours a week of which eight of those are spent resting.

Her on-call payment is around 4 an hour. "It can be very, very demeaning and it does make you think that the six years we spend training is less than worthwhile," she said.

Dr Trevor Pickersgill of the British Medical Association said doctors' hours can vary, according to where they work and what their specialism is.

The majority work on an on call rota. This means they spend a proportion of their nights and weekends on call in case an emergency arises.

In busy hospitals, they may be working flat out through the night, he said.

Under the New Deal, junior doctors should get eight hours' rest if they work through the night.

"In many cases, they do not," said Dr Pickersgill.

"Research shows that sleep deprivation means you do not perform properly, you make errors and you are not up to scratch.

"It makes it difficult to provide a quality service to patients."

Dr Seymour says she often works 28 hours with only a few breaks
He thinks senior doctors should take on a larger role in emergency care.

But he admits there are not enough consultants to go around the increasing number of patients being seen by hospitals.

From April, junior doctors' pay will range from 16,710 for a house officer to 33,965 for a specialist registrar at the top end of the pay scale.

Most junior doctors are paid half their normal hourly rate when they are on call.

Dr Seymour describes her working day
See also:

01 Feb 99 | NHS pay 99
What doctors and dentists get
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