¿Se sobrecarga a los médicos residentes? Estudio descriptivo sobre la falta de libranza de guardias de los médicos residentes y análisis de sus consecuencias docentes en la provincia de Valencia

Carrasco, Juan Pablo; Ferrando, María Vicenta Pérez; Jiménez, Marta Beatriz Briggs; Martín, Jorge; Martínez, Elsa; Martínez, Luis Carlos Sánchez; Paz, Verónica Sugey; Pérez, Julio; Ramírez, Elena; Martínez, Domingo Antonio Sánchez; Vega, Sara Torres; Viadel, M.a Luz Hernández

doi:10.1016/j.edumed.2020.09.005

Cited by 8 publications

(9 citation statements)

References 17 publications

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“…As for the results from the regional studies conducted in Spain our results show similarities with the gures of non-compliance with breaks after duty hours (Carrasco et al 2020;Cerame et al 2021). In this sense, a generalized phenomenon of non-compliance with labor regulations is observed throughout the country.…”

Section: Discussionsupporting

confidence: 79%

“…One of the problems which has been studied in two Spanish regions: Madrid and Valencia, is that resident physicians are not allowed to rest after a 24h on-call shift in 20-30% of cases (Carrasco et al 2020;Cerame et al 2021), percentages that could reach to 60-70% in surgical specialties. There are no studies in Spain, other European nations or at the European level which describe junior doctors' realities across specialties and regions or EWTD compliance.…”

Section: Introductionmentioning

confidence: 99%

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Resident physician duty hours, resting times and European Working Time Directive compliance in Spain: a cross sectional study.

Martínez

Carrasco

Estrella

et al. 2023

Preprint

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Background: There is a growing interest in understanding the impact of duty hours and resting times on training outcomes and the wellbeing of resident physicians. However, to this date no state-wide analysis exists in any European country. Objectives: Our aim is to describe the shift work scheduling and to detail the degree of compliance with the Spanish legislation and the European Working Time Directive (EWTD) of Spanish resident physicians, focusing on territorial and specialty distribution. Material and methods:A descriptive cross-sectional analytical study was designed through an online survey adapted from the existing literature. Results: Out of the 2,035 surveyed resident physicians undergoing PGT in Spain, 80.49% exceeded the 48h per week limit set by the EWTD and 13% of them did not rest after a 24h on-call shift. The mean number of on-call shifts per month was 5.10, with the highest mean reported in Asturias, La Rioja, and Extremadura. 51.6% of respondents had a day-off after a Saturday on-call shift. Significant differences are observed by region and type of specialty. Conclusion: Resident physicians in Spain greatly exceed the established 48h/week EWTD limit. Likewise, non-compliance with labor regulations regarding mandatory rest after on-call duty and minimum weekly rest periods are observed.

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Section: Discussionsupporting

confidence: 79%

Section: Introductionmentioning

confidence: 99%

Resident physician duty hours, resting times and European Working Time Directive compliance in Spain: a cross sectional study.

Martínez

Carrasco

Estrella

et al. 2023

Preprint

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“…Existe poca bibliografía que aborde la naturaleza y el alcance de este fenómeno en España, no existiendo estudios a nivel estatal. Sí se han realizado comunicaciones sobre el fenómeno en la Región de Murcia (7) y se han realizado estudios en la provincia de Valencia (8). Estos describen una situación en la que cerca del 30% de los residentes no libran las guardias de manera habitual.…”

Section: Introductionunclassified

Estudio descriptivo sobre libranza de guardias de Médicos Residentes de Madrid: Efecto de la huelga de 2020 en el cumplimiento de los descansos obligatorios

Campo¹,

Gámez

Coucheiro³

et al. 2021

Rev Esp Edu Med

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Antecedentes: Este estudio tiene como objetivo describir el grado de cumplimiento de los descansos obligatorios tras las jornadas de trabajo de 24 horas (guardias) en el colectivo de médicos residentes en la Comunidad de Madrid y el efecto que la huelga de residentes de 2020 ha tenido en el cumplimiento de dichos descansos. Métodos: Se ha diseñado un estudio descriptivo observacional transversal a través de una encuesta online anónima adaptada de la bibliografía existente. Resultados: Antes de la huelga de residentes el 27,2% de los encuestados no realizaban los descansos obligatorios después de las guardias. El descanso semanal obligatorio de al menos 36 horas no se respetaba hasta en el 87% de los casos. Después de la huelga de residentes, estos porcentajes se han reducido a un 19,8% y un 34,5% respectivamente, con significación estadística comparándose con los porcentajes previos (p<0,05). La media de guardias realizadas en la muestra era de 5 al mes, lo que supera el máximo legal de horas semanales. Conclusiones: Se constata la vulneración de los derechos laborales de los residentes en un importante porcentaje de los residentes en lo relativo a los descansos obligatorios post-guardia y descansos semanales. La huelga de residentes ha reducido la incidencia del fenómeno, pero sigue siendo un problema relevante para la salud de los residentes y la seguridad del paciente. Background: This study aims at describing the absence of mandatory rest periods after a 24h on call shift in resident physicians in the region of Madrid. It also tries to elucidate the effect which the 2020 resident physician’s strike has had in this phenomenon. Materials and methods: A descriptive observational cross-sectional study has been carried out through an anonymous survey adapted from the available literature. Results: Before the resident’s strike up to 27,2% of the residents surveyed could not enjoy mandatory resting periods after a 24 hour on-call shift. The mandatory weekly rest of at least 36 hours was not done in up to 87% of the cases. After the residents' strike, these figures have been reduced to 19.8% and 34.5% respectively, with statistical significance comparing with previous percentages (p <0.05). The average number of 24 hours on call shifts residents had to work per month was 5, which exceeds the maximum weekly hours allowed by law. Conclusions: The findings reveal a violation of resident physician labor rights in relation to the mandatory days-off after 24-hour on call shifts and weekly breaks. The resident physician’s strike has reduced the incidence of the phenomenon, but it remains a relevant threat to resident physician’s health and patient safety.

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“…In recent years, the balance between these two facets has been put into question due to an increase in healthcare demand and the organizational difficulties created by the budget cuts enacted after the 2008 economic crisis. One of the examples which could illustrate this imbalance can be found in the systematic non-compliance of labor rights in relation to compulsory resting times after 24-hour on-call shifts (3)(4). One particularity of the system is that its access and evaluation periods are centralized at the state level.…”

Section: Introductionmentioning

confidence: 99%

The Spanish medical specialist training perception of the COVID-19 pandemic impact in their emotional health and training, a cross-sectional observational study

Martínez

Campo²,

Mirallas

et al. 2022

Rev Esp Edu Med

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Specialist training in Spain is conceptualized as a dual system regulated as both a public employment and a graduate training program. Due to the global pandemic created by COVID-19 which hit Spain in March 2020, the Spanish specialist training system underwent temporary but major restructuring, giving priority to labor aspects within the system. The main goal of the study was to assess how resident physicians in Spain perceive the impact of the COVID-19 pandemic on their training and on their emotional wellbeing. A descriptive observational cross-sectional study was carried out where data was gathered through an anonymous survey distributed to all resident physicians in Spain during a period of two weeks in November 2020. The results were analyzed by the statistical package SPSS v.25. A total of 2889 responses were collected and analyzed. More than 80% of the residents stated that training had worsened and 47% indicated that working in COVID-19 related duties had not contributed to their core or specialized curriculum. The increase in 24h on-call shifts and in regular working hours, the lack of supervision and the suspension of elective surgeries were the variables associated with a major training impact and psychological distress. The COVID- 19 pandemic has severely affected residency programs, fundamentally in the acquisition of specialized competencies. This situation must be urgently addressed by health authorities at government and hospital levels in order to prevent important shortcomings in the training of future specialists. La formación de especialistas en España se conceptualiza como un sistema dual regulado tanto como una condición laboral como un programa de formación de postgrado. Debido a la pandemia global por COVID-19, cuya primera fase afectó a España en marzo de 2020, el sistema español de formación de especialistas sufrió una reestructuración temporal pero importante, dando prioridad a los aspectos laborales dentro del sistema. El objetivo principal del estudio es cómo los médicos residentes en España perciben el impacto de la pandemia de COVID-19 en su formación y en su bienestar emocional. Se realizó un estudio descriptivo observacional transversal donde se recogieron los datos a través de una encuesta anónima distribuida a todos los médicos residentes en España durante un período de dos semanas en noviembre de 2020. Los resultados fueron analizados mediante el paquete estadístico SPSS v.25. Se recopilaron y analizaron un total de 2889 respuestas. Más del 80% de los residentes afirmó que la formación había empeorado y el 47% indicó que trabajar en tareas relacionadas con COVID-19 no había contribuido a su plan de formación. El aumento de las guardias de 24 horas y del horario regular de trabajo, la falta de supervisión y la suspensión de cirugías programadas fueron las variables asociadas a un mayor impacto formativo y psicológico. La pandemia COVID-19 ha afectado gravemente a los programas formativos de los residentes, fundamentalmente en la adquisición de competencias especializadas. Esta situación debe ser abordada por las autoridades sanitarias a nivel gubernamental y hospitalario para evitar marcdas deficiencias en la formación de los futuros especialistas.

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¿Se sobrecarga a los médicos residentes? Estudio descriptivo sobre la falta de libranza de guardias de los médicos residentes y análisis de sus consecuencias docentes en la provincia de Valencia

Cited by 8 publications

References 17 publications

Resident physician duty hours, resting times and European Working Time Directive compliance in Spain: a cross sectional study.

Resident physician duty hours, resting times and European Working Time Directive compliance in Spain: a cross sectional study.

Estudio descriptivo sobre libranza de guardias de Médicos Residentes de Madrid: Efecto de la huelga de 2020 en el cumplimiento de los descansos obligatorios

The Spanish medical specialist training perception of the COVID-19 pandemic impact in their emotional health and training, a cross-sectional observational study

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