The depressing picture painted by the anonymous junior doctor certainly reflects the current situation on my wards. However, we can't turn the clock back-no matter how much the Royal College of Surgeons would like to-and the amount of structured teaching that foundation doctors undergo is far greaterthan when I was a junior trainee 15 years ago. Two things have changed forthe worse. Firstly, the fragmentation of rotas means that I never have the same foundation doctor on a ward round twice in a row. I therefore cannot teach with any continuity-and teaching isn't easy when your trainee colleagues don't know anything about the patients. The solution may be to corral acute receiving and acute nights into separate jobs-treat them like emergency medicine jobs-because acute receiving and ward work do not mix in contemporary medicine.
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