Hospital medicine (London, England : 1998)
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The educational and training quality of flexible training posts compared very well and in some instances was better than that obtained in full-time training. The hours of work were fewer, but as a proportion not as small as is sometimes recognized by the Colleges and is comparable with many full-time training programmes in other European Union countries.
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When the conduct, performance or health of a doctor in training is called into question, there is often confusion about the roles and responsibilities of the parties involved. Where does training stop and employment begin? When should poor performance trigger intensified training, and when should it lead to dismissal? How much information should be transferred from employer to employer as a trainee moves around a training programme? This article describes one Deanery's approach.
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Since the 'new deal' was introduced, new working patterns such as shift systems have become increasingly common. The current study examines how these shifts might be improved. The results suggest that organizational changes such as increased numbers of ward clerks and support workers can minimize the negative impact of shift systems. However, shifts remain unpopular among junior staff and the authors conclude that new working initiatives must be properly evaluated before their widespread implementation.