NHS heart surgeons could be trained in India to gain enough experience

By Dean Nelson, New Delhi, The Telegraph

NHS heart surgeons will soon have to be trained in India because European Union rules on working hours are stopping young doctors getting the operating theatre experience they need, according to one of India’s leading cardiac specialists.

Seven NHS registrars will go to India in the next few months to work up to 18 hours a day, performing four heart operations per shift, to get the experience they need to become consultants in Britain, according to Devi Shetty of Narayana Hrudayalaya cardiac hospital in Bangalore.

“It’s only a matter of time before those in Europe and the United States have to send their surgeons to India for training,” he said. “In India the number of procedures by every centre is very large, so in a very short period a surgeon gets exposed to a very large number of surgeries.

“Then there’s the restriction of the work hours. It’s stupid because when you’re young you’re supposed to work very hard and learn the skills and when you get older you work fewer hours. But no one can work more than 48 hours a week. So any surgeon under the current UK work restriction, by the time he finishes his training it’s time to retire.

“There is something seriously wrong here which needs to be changed.”

Simone Speggiorin, a doctor at London’s Great Ormond Street Hospital, was sent to work under Mr Shetty, a former Guy’s Hospital registrar.

He told the British Medical Journal that while training hospitals such as Great Ormond Street offered great theoretical preparation for surgeons, juniors were “not allowed to train properly because of too many regulations”. Juniors had so little practical operating experience that their real training began when they became a consultant.

“That isn’t safe,” he said. According to Mr Shetty, seven “intermediate level” NHS surgeons have volunteered to follow in Mr Speggiorin’s footsteps to fast-track their training. He said the working-time restrictions that limited surgeons to 48 hours per week would lead to mediocrity rather than surgical excellence.

“I used to work at Guy’s. I had the opportunity to do a large number of surgeries compared to those working in the NHS now,” said Mr Shetty.

“I worked most of the weekends, on-call duties, emergency procedures. I worked 16 to 18 hours per day and I still do. You can’t do a 9-to-5 day and aspire to be a cardiac surgeon,” he said.

The Royal College of Surgeons said trainees had gone abroad to gain experience before the working time directive came into force.

This time can count towards their qualifications, depending on whether the General Medical Council approved the scheme before they left.

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