Too many junior doctors are left unsupervised on wards overnight and are missing out on training because of to the European Working Time Directive, a report warned yesterday.
The NHS is "too reliant" on trainees to provide out-of-hours care for patients, the Government-ordered review said.
Some older consultants are reluctant to work later hours and prefer to stick to a standard week, which affects trainees, according to the review's author, Professor Sir John Temple.
Sir John examined the impact on medical training of the European Working Time Directive, which cut the maximum number of hours doctors could work to 48.
He concluded that trainees could still receive high-quality training in a 48-hour week, but not if they continue to had such a major role in providing out-of-hours care.
Trainees also suffer from being poorly supervised, and their chances for learning during the day are reduced because they have to fill gaps in rotas, he said.
Sir John said consultants should work more flexibly and be more "directly responsible" for patient care around the clock.