Interns routinely seeking consent for procedures without adequate training 

Six out of 10 interns said they had felt pressured into obtaining consent from a patient on at least one occasion.

Interns are routinely involved in obtaining consent from patients without adequate training or supervision, according to a new study.

A survey of newly qualified medical graduates working as hospital interns revealed the vast majority of them had obtained consent for a procedure including ones which they had not witnessed before.

Six out of 10 interns said they had felt pressured into obtaining consent from a patient on at least one occasion.

The Irish Medical Council’s Guide to Good Practice and Ethics states that no part of the consent process should be delegated to an intern unless the procedure is a minor one with which the intern is very familiar and the intern’s supervisor has clearly explained the relevant information about the procedure to them.

However, the survey of almost 150 interns carried out at the end of 2021, found that more than 7 out of 10 reported that their medical supervisor had not explained procedures to them prior to them obtaining consent.

Only a third of interns surveyed said they were aware of guidelines in relation to the practice of obtaining consent.

The research, which was led by a team of doctors at Connolly Hospital Blanchardstown, said the results were largely unchanged from a similar survey that was carried out in 2016.

In another finding, 16% of interns reported that they had gotten a patient to sign a consent form without fully discussing the procedure and its risks.

However, the figure was down from 35% in the earlier study.

Health risks

According to the latest research which is published in the Irish Journal of Medical Science, half of all interns said that they did not routinely include the risks of heart attack, stroke, and death as part of obtaining consent from a patient.

Over 99% of interns said they were not usually observed by a more senior doctor when obtaining consent from a patient.

Nine out of 10 interns said they were expected to obtain consent from patients on a regular basis.

The study acknowledged that there had been a statistically significant improvement in the proportion of interns who have had a procedure explained to them by a senior supervisor — up from 16% to 29% in the latest survey, The report noted that obtaining valid informed medical consent had become increasingly pertinent in an era of increasing medico-legal litigation and medical misinformation.

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Interns reported that they most commonly consented for procedures under local anaesthetic and sedation.

The authors of the report said the results from the research showed interns remain heavily involved in the consent process on a regular basis.

“This is unfair on our most junior doctors and on patients,” they observed.

The report recommended that steps should be taken to ensure guidance issued by the Irish Medical Council was adhered to and that “this deficiency must be highlighted to senior clinicians".