Higher surgical trainees (HSTs) have witnessed their total work-hours during training reduced from the pre-European Working Time Directive (EWTD) era of 80,000 h to the current 21,000 h. In addition, with the establishment of hybrid rotas, reduced service training opportunities and the implementation of national guidelines relating to 'emergency surgery out-of-hours only', it is estimated that in 2009 the average time spent training consultant surgeons will decrease to 7640 h, i.e. 10% of their predecessors (White et al. 2005).
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