There are simply not enough doctors working in the NHS to do the job as well as the government leads everyone to believe

Dr Susan Robinson

The authors said the findings were unsurprising and urged action to improve the working conditions of A&E doctors.

Dr Susan Robinson and colleagues surveyed 350 of the UK's 479 emergency medicine consultants.

Respondents were asked to detail the frequency and "stressfulness" of their work.

High scores

Almost 45% scored highly for stress. This compares with scores of between 21% and 28% for studies of other UK consultants and 18% for the general working population.

The study found that the number of hours worked per week was strongly linked to stress.

Full-time consultants had worked an average of 55 hours in the NHS in the week of the survey, although figures ranged from 15 hours to 168 hours.

Those working part-time had clocked up between eight and 117 hours that week.

Dealing with NHS managers and pressures on family life as a result of long hours were also regarded as stress factors.

Nevertheless, two-thirds of doctors said they were extremely satisfied that they had chosen a career in A&E medicine.

Consultants said they liked the variety and adrenaline rush of the speciality as well as the level of contact they have with patients.

The authors urged action to improve the working lives of these doctors.

They called on the NHS to "provide employment environments in which doctors can practise effectively without compromising their own health".

'Unsurprising'

Dr Robinson, who is an A&E consultant at Addenbrooke's Hospital in Cambridge, said the results did not come as a surprise.

"We had a feeling that there was a degree of psychological distress generally," she said.

"But we felt that changes in the NHS recently and certainly the way colleagues were talking there was a need to look at this issue."

Dr Robinson said the results suggested there was a need for further research.

She added that many of the problems stemmed from the fact that consultants were being asked to do too much and were overworked.

"The problem is that there are simply not enough doctors working in the NHS to do the job as well as the government leads everyone to believe," she said.

The Department of Health said much was being done to improve staffing in hospital emergency departments.

A spokesman said: "Our plans to reform emergency care include recruiting 40% extra A&E consultants and 600 more A&E nurses by 2004 and to help other NHS staff take on some of the work of consultants.

"International recruitment provides a short term solution and the benefits in an increase in medical training places will be seen over the next few years.

The nature of doctors' workloads is changing as nurses and other healthcare professionals expand their role."