Editor - Chaponda and colleagues recently highlighted the impact of shift working on patient care continuity and learning opportunities for acute medicine trainees (Clin Med August 2009 pp 323-6). One of the (perhaps) unexpected results they included in their table (but did not discuss), was the significant reduction in specialist registrar (SpR) diagnosis differences from the clerking diagnosis (from 35.8% in 2006 down to 24.3% in 2008, odds ratio 0.58 (0.40-0.83), p=0.002).
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