Sir,

Rahman's report of his local, prospective study provides further evidence of the inadequate opportunities to complete full intraocular procedures available to SHOs, especially in these days of extreme pressure to maximise throughput. Once again it demonstrates that this cannot be explained in terms of the pressure of larger list sizes. What is particularly impressive in his report is the way in which this information was used to reverse the situation and substantially increase the opportunities available to SHOs. While we would agree that negative comments on their own do not lead to change, his work shows the importance of listening to the concerns of junior doctors and acting to address them. We hope that the striking success of his department in doing so will encourage other departments to follow their example.