Govind Sharma
JAMMU, Aug 12: Though National and International recommendations on work hours clearly state that nobody can be forced to work more than 48 hours in a week and 12 hours in one stretch, yet authorities of Government Medical College and Hospital (GMCH), Jammu and associated hospitals do not care about that, where resident doctors are forced to overwork. This burden of overwork is not only affecting their academic performance and research work but also having serious implications on patient health and many times leads to violent clashes between them and attendants.
According to the reports, an anesthesia resident in these hospitals is forced to work for 24 hours continuously while gynae, pediatric, surgery and medicine residents are forced to work for continuous 36 hours.
Briefing about his typical work week, an anesthesia resident of GMCH who declined to be identified said, “A typical work week of an anesthesia includes three duties and three regular days of work. A regular day of work includes OT duty, ICU/NICU/PICU duty, teaching seminars, thesis work, and running OPD services. While a duty day means 24 straight hours of emergency/casualty posting and OT service and responding to CPR calls. This “duty” day then blends into the next “regular” work day without a break.
He said that the situation worsens in case of gynae, pediatrics, surgery and medicine residents who have to work for continuous 36 hours. “This sleep-deprived duty roster of resident doctors continued to operate for full 3 years, i.e., the duration of residency and the ill effects of these can clearly be seen in countless cases of medical negligence and regular cases of violence among resident doctors and attendants of patients”, he added.
Another resident doctor said that the instruction No 13 of a letter No S-11014 /3/91 ME(P) sent by Ministry of Health and Family Welfare, Government of India to all states and UT administration issuing instructions regarding implementation of Uniform Central Residency Scheme following the directives of the Supreme Court in its judgment dated 25.9.87 in writ petition No 348-352 of 1985, states that: “Continuous active duty for resident doctors will not normally exceed 12 hours per day and subject to exigencies of work the resident doctors will be allowed one weekly holiday by rotation. The resident doctors will also require to be call on duty not exceeding 12 hours at a time. While the junior residents should ordinarily work for 48 hours per week and not more than 12 hours at a stretch subject to the condition that the working hours will be flexible as may be decided by the Medical Superintendents concerned keeping in view the workload and availability of doctors for clinical work.”
“However, ignoring the instructions of Union Ministry, the authorities are making the resident doctors to work more than recommended duty hours by taking advantage of the flexibility given by law in routine which otherwise should only be used as a special measure”, he alleged and added that this practice is continuing in routine for last many years with senior faculty and authorities justifying this excessive workload of residents as tradition of good training process.
On the conditions of anonymity, a pediatric resident stated that as majority of residents are academic residents they are not in a position to express their reservations to senior consultants and concerned HODs due to fear of failure in examinations and getting less marks in assignments.
“Even the International Labour Organization recommendations prohibit more than 48 hours of work in a week and 12 hours in a single stretch then why the authorities while stretching our duty hours forget this proven fact that errors and accidents increase in mental and physical work when duty hours are stretched beyond 10-12 hours continuous duty”, he said adding this much workload is enough to do blunder and endanger human life.
When contacted, Principal, GMCH Jammu, Dr Ghansham Dev Gupta said, “The working hours of resident doctors have been fixed as per Health Ministry guidelines and nobody can force them to overwork. I never heard from any resident doctor about this (overworking) but if this is true I will take up the matter with all HoDs and ensure that no resident is not harassed unnecessarily”.
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