The European Working Time Directive has resulted in a marked reduction in junior doctors’ working hours.1 Although this has undoubtedly reduced exhaustion, it has also had implications for postgraduate training. Trainees will inevitably have fewer hours of clinical experience; hence the need for more formalised training, competency and knowledge-based assessments.2 Moreover, changes to postgraduate training, including Modernising Medical Careers (MMC) and other government initiatives, may lead to further shortening of higher specialty training to meet demand. In respiratory medicine, specialist registrars are expected to have carried out 250 bronchoscopies during their 5 years of training.3 Previous data suggest there may be a reduction in higher specialist training opportunities in posts compliant with the European Working Time Directive, but the evidence is limited.4

My impression is that there has been a noticeable reduction in bronchoscopy procedures carried …