Public Release: 

Trust doctors: the new lost tribe?

Letter: Are trust doctors the new lost tribe?

BMJ

Delivery of acute care in the NHS is going to increasingly depend on doctors who are receiving little educational supervision as the number of trust doctors (doctors in non-training grades) rises, say researchers from Leeds University in this week's BMJ.

Their survey of acute Trusts in Yorkshire found that the number of trust doctor posts has increased at least fivefold over the past four years. Furthermore, the current number will more than double in the near future as trusts try to meet both service and hours requirements and are unable to employ more doctors in training.

Thirty-six trust doctors in the region responded to a separate questionnaire about education and training. Sixteen reported that they had an educational supervisor and only six had appraisals. The most common career aim was a consultant post in the United Kingdom, and the main reasons for taking a post as a trust doctor were as a "stop gap" or to gain experience in a particular specialty.

Although trust doctors come under the legal requirements of the European working time directive, only 12 reported working 48 hours a week or less.

"Our survey shows the number of trust doctors is increasing dramatically," say the authors. These are junior doctors with educational needs, yet they do not receive the same educational supervision as their training grade equivalents.

Trusts say they cannot meet the requirements of the new deal or the European working time directive without employing trust doctors. This survey has put figures to a quietly growing problem that must now be tackled, they conclude.

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