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Agreed. A and E is not good for making money or working soft hours. It's first and foremost a fun specialty. Only worry is about consultant being physically present. Probably not needed (I tend to get in from home before the residents in other specialties arrive). If the consultant is physically up and working, it means seeing a lot of minor/ self limiting conditions (not a problem in itself, but if I wanted to do it full time, I'd have gone into general practice, spent less time in training, made more money and not done nights on call). Also, there are only so many sick patients- to have enough consultants to make this sort of shift work possible (correct me if I'm wrong, didn't someone work out that this needs 11 - 15 consultant per department) would dilute the experience for each one... unless really went down the Emergency Physician route (my own choice). But yes, lets pull forwards as a specialty. We should be the best able to assess and resuscitate critically ill patients. If we lack technical skills to do so (RSI, ultrasound, etc), then lets bring these skills into the specialty rather than shifting the patients out. Above all, lets keep the fun parts within our specialty. Matt Dunn %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%