Stepping Into the Night: The Preparedness of Newly Qualified Doctors for Out-of-Hours Work

Abstract

Background

The transition from medical student to doctor is a significantly stressful event with a perceived lack of preparedness. A comprehensive exploration of the facilitators and barriers to preparedness for out-of-hours specifically, such as night duty, is lacking. This study aims to investigate the perspectives of newly qualified Irish doctors (interns) regarding their readiness for out-of-hours work, the levels of support available and the influence of their medical education on readiness.

Methods

A survey using both quantitative and qualitative data was developed and distributed amongst 145 interns in one Irish regional ‘network’ using nonprobability sampling. Quantitative data were analysed using nonparametric methods of Likert scale responses. Qualitative data underwent thematic analysis using Braun and Clarke's approach.

Findings

Seventy-seven respondents met inclusion criteria. Of participants, 88.3% disagreed with feeling prepared for out-of-hours, a sentiment corroborated by qualitative expressions of fear and apprehension. Themes emerged regarding general preparedness, support, and the hidden curriculum. Seeking support presented challenges, often met with resistance. Isolation and post-call anxiety were recurrent sentiments. Participants believed medical education had inadequately prepared them, emphasising theoretical knowledge at the expense of practical skills for real-world scenarios.

Conclusion

This study highlights the anxiety and isolation experienced by new doctors, underscoring a pervasive sense of unpreparedness, inadequate support structures and a disconnect between medical education and the practical demands of out-of-hours clinical work. These findings support current literature and emphasise the need for enhanced training, emotional support and better alignment between education and clinical realities for out of hours.