Kathryn Hewitt shudders at the memory of constant fatigue during her early days as a junior doctor. She worked 10 hours every weekday and was on duty every fifth night and every fifth weekend.
There was no sympathy from her bosses, the surgeon consultants at University College hospital in London. While she was regularly averaging 80-hour weeks, they remembered doing 100 when they were juniors - and thought the new trainees had it easy.
Miss Hewitt recalls: "The worst thing was starting a full day's work on a Monday having been at the hospital since the previous Saturday. I can't describe the extreme level of tiredness. I'd go through the list of patients with the consultant, trying to be perky and enthusiastic. At that level of exhaustion, you lose the will to live."
During the night shift it was often possible to snatch a few hours' sleep in the on-call room at the nurses' hostel. She recalls the cockroaches in the corridors and the night when she found her bed occupied and slept instead on a trolley in the fracture clinic.
This was not a story from long ago. Miss Hewitt is 29 and the time she was describing was 1998. As she progressed up the junior doctor training ladder at other hospitals in Bournemouth and London, she worked other rotas that were just as taxing.
Life started to improve four years ago. Now at the Whittington hospital in north London where she is a registrar (the top junior grade), the hours are not much longer than for many office workers.
She works from 8am to 5.30pm on most weekdays and is on call until 8pm on every sixth night. She also works either days or nights on two weekends out of seven. There is always a day off after night duty and so marathon shifts are no longer required.
A dramatic improvement in her social life was accompanied by a big rise in pay. Miss Hewitt gets a basic salary of £30,000, but the evening and weekend work bumps up her banding and she grosses £50,000, plus £1,800 London weighting.
Yet her hospital has admitted to the Guardian that it has not yet done enough for its junior doctors to comply with the EU directive. Margaret Boltwood, director of human resources, said shifts in the general surgery department where Miss Hewitt works will remain legal after Sunday, but it may take several months to get paediatrics right.
To satisfy the directive, the trust has to recruit at least three extra staff in a specialty with doctors in short supply. An impending reconfiguration of children's services in north London complicates matters.
There is another problem Ms Boltwood shares with managers across the NHS. It will not be good enough to have a shift system that complies with the law on paper. To stay legal, hospitals will have to ensure that junior doctors work those shifts in practice, stopping promptly when the next shift comes on duty.
Lee Dvorkin, a general surgical registrar at the Whittington, said taking breaks was sometimes easier said than done. "It's reasonable to take time for lunch, but you can't make it compulsory. Surgery doesn't work that way," he said.
"During the day there will be times when natural breaks occur. But if you are operating at 4.55pm and your shift ends at 5pm, it would be unreasonable to drop your instruments, even if a colleague was ready to take over."
Mr Dvorkin appreciates a better work-life balance, but worries that the reduced time at work cuts down the experience he will need to qualify in six years as a consultant, practising without supervision.
Miss Hewitt agrees. "My consultant strongly believes the reduced hours are detrimental to surgeon training. That makes our working relationship difficult. The consultants think we are nobbing off work early. It's hard to say: I'm going off at 8 because my shift is finished."
She added: "It's depressing to think the reduced experience may add to the 19 years it takes to qualify as a consultant."
