Vanishing experience in training for obstetric general anaesthesia: an observational study

Abstract 

Background

Changes in the delivery of anaesthesia for caesarean section have meant that trainee experience in obstetric general anaesthesia has steadily declined. In the UK, working patterns for trainees have changed significantly with the introduction of the New Deal in 2000 and the European Working Time Directive in 2004. Because of an impression that training opportunities had worsened during this period we have reviewed data in obstetric general anaesthesia at St James’s University Hospital since 1998.

Methods

Data were collected retrospectively from prospective audit information contained within annual reviews collated by the Department of Obstetric Anaesthesia, St James’s University Hospital Leeds between 1998 and 2006. Results before and after the implementation of training changes in 2000 and 2004 were compared.

Results

Since 1998 the total number of obstetric general anaesthetics given per year has continued to decline. The number of trainees increased from 23 in 1998 to 40 in 2006, with the main increase occurring between 2002 and 2003. The mean number of obstetric general anaesthetics given per trainee fell to 1 per year in 2006.

Conclusion

Since 1998 training opportunities in general anaesthesia for caesarean section at St James’s Hospital have continued to decline. This reflects both changing trends in the delivery of anaesthesia for caesarean section and also changes in training hours and trainee numbers.

Keywords: Obstetric general anaesthesia, Training, New deal, European Working Time Directive