In the United Kingdom, junior doctors are qualified medical practitioners working whilst engaged in postgraduate training. The period of being a junior doctor starts when they qualify as a medical practitioner following graduation with a Bachelor of Medicine, Bachelor of Surgery degree and start the UK Foundation Programme, it culminates in a post as a Consultant, a General Practitioner (GP), or some other non-training post, such as a Staff grade or Associate Specialist post. The term junior doctor currently incorporates the grades of Foundation doctor and Specialty registrar. Prior to 2007 it included the grades of Pre-registration house officer, Senior house officer and Specialist registrar. During this time junior doctors will do postgraduate examinations to become members of a Medical royal college relevant to the specialty in which they are training, for example Membership of the Royal College of Physicians for doctors specialising in Internal medicine, Membership of the Royal College of Surgeons for doctors specialising in surgery or Membership of the Royal College of General Practitioners for doctors specialising in family medicine. Doctors typically may be junior doctors for 8–20 years, and this may be extended by doing research towards a higher degree, for example towards a Doctor of Philosophy or Doctor of Medicine degree. In England there are around 71,000 junior doctors. Working hours In Europe and the US there has been some reduction of the working hours of doctors who are in postgraduate training, in line with recommendations and legislation aimed at improving patient safety and doctors’ working conditions. In 1991 the government, the NHS and the British Medical Association (BMA) agreed a package of measures on working hours, pay and conditions which was called the New Deal for Junior Doctors. The Doctors' duty hours, which were felt to be excessive, were reduced to a maximum average of 56 hours actual work and 72 hours on call duty per week, although the change was not enforced until 1 December 2000. The European Working Time Directive (EWTD) sets out minimum health and safety requirements for the organisation of working time. The EWTD required the average working week to fall to 48 hours or less by 2009. The shortening of junior doctors' working hours had implications for how training programmes are organised, especially for specialties such as surgery where there was a tradition of maximising the hours of experience. Most studies that have looked at a reduction of junior