© Royal College of Physicians 2014. All rights reserved. 141
Clinical Medicine 2014 Vol 14, No 2: 141–4 MEDICAL EDUCATION
Authors: Abhay K Das,
A
Oliver J Corrado,
B
Zuzanna Sawicka,
C
Safirul Haque,
D
Sujo Anathhanam,
E
Lopa Das
F
and Robert West
G
Junior doctors’ understanding of alcohol units
remains poor
A survey of 586 trainee doctors in Yorkshire was undertaken to
ascertain current junior doctors’ knowledge and understanding
of alcohol units. Approximately 18% of trainees had no
knowledge of alcohol units despite the fact that 82% believed
they had a good knowledge. Once again, those who did not
drink alcohol knew less about alcohol units than those who did.
Little progress seems to have been made on this important
subject since our previous survey 7 years ago. Further steps
must be taken to ensure that junior doctors are taught about
alcohol units during the course of their training so that they are
able to counsel patients appropriately.
KEYWORDS: Alcohol units, awareness, trainee doctors, knowledge,
patients
Introduction
Many people enjoy drinking alcohol without it having any
deleterious effects on their health or lifestyle. However, people
regularly present to a variety of heath services with problems
relating to alcohol consumption. Although economic
recession increases abstention from alcohol, it also increases
the frequency of binge drinking.
1
Excess alcohol consumption has a significant impact on the
National Health Service (NHS). Between 2010 and 2011, alcohol
was responsible for 1.2 million hospital admissions (NHS
Information Centre 2011) and the cost of alcohol-related ill
health to the NHS in England was estimated to be £3.3 billion
for the same period.
2
In England, 18% of the adult population
(7.6 million) drink at a level that would regarded as hazardous
to their health, and another 7% (2.9 million) show evidence of
some alcohol-related harm.
3
Early identification of the problem and an appropriate, non-
stigmatising response from medical professionals can improve
outcomes. 5–10 minutes of advice (‘brief intervention’) by
‘competent practitioners’ can be highly effective. This approach is
endorsed by the National Institute for Health and Care Excellence
(NICE).
4
The effect of acute intoxication, chronic toxic effects and
addictive propensity of alcohol are directly proportional to the
amount of alcohol consumed. The quantity of alcohol is measured
in units instead of ‘standard drinks’ because the strength of
alcohol and size of the measures vary widely. It is important that
the public at large understand alcohol measurements in units,
but it is crucial that junior doctors also understand alcohol units
because they need to be in a position to counsel their patients
appropriately.
In our previous survey in 2005,
5
we found that just over half
(58%) of the doctors (hospital doctors and general practitioners
ABSTRACT
Authors:
A
consultant physician, Dewsbury and District Hospital,
Dewsbury, UK;
B
consultant physician, St James’s University
Hospital, Leeds, UK;
C
consultant physician in elderly medicine,
Pinderfields General Hospital, Wakefield, UK;
D
ST6 in elderly
medicine, Halifax General Hospital, Halifax, UK;
E
specialty doctor in
adult psychiatry, South West Yorkshire Partnership NHS Foundation
Trust, Priestley Unit, Dewsbury and District Hospital, Dewsbury, UK;
F
ST4 in elderly medicine, Pinderfields General Hospital, Wakefield,
UK;
G
professor of biostatistics, University of Leeds, Leeds, UK
Box 1. The study questionnaire.
1 Do you drink alcohol? Yes/No
2 Do you understand alcohol measurement in units? Yes/No
3 What is the recommended maximum DAILY alcohol intake in
units for:
Males . . . units
Females . . . units
‘Don’t know’
4 How many alcohol units does a 750 ml bottle of bottle of
wine (12%) contain? . . . units
5 Please calculate the WEEKLY consumption of alcohol in units
for the following four drinking patterns:
(a) One 750 ml bottle of whisky (40%) per week . . . units
(b) 3 pints of lager (4%) daily . . . units
(c) 1 glass (200 ml) of wine (13%) twice daily . . . units
(d) 2 large (100 ml each) sherries (20%) 3 days a week . . . units
6 Please state your grade and your year of training (please circle):
GPVTS trainee Year 1, 2, 3
Foundation trainee year 1, 2
Hospital specialist trainee year 1, 2, 3, 4, 5, 6, 7, 8
GPVTS = general practice vocational trainees.