Safe working hours - doctors in training a best practice issue

Abstract

In 1995, the Australian Medical Association launched its Safe Working Hours campaign. By 1998, this had been developed into a National Code of Conduct that continues to resonate in the Australian public health system. However, and particularly in respect of Doctors in Training (DITs) who continue to work long hours, there are levels of resistance to proposals that seek to re-organise work or change prevailing professional and cultural expectations. Long working hours have substantial impacts on a DIT's capacity to consistently deliver high quality patient care, dilute the effectiveness of their training regime and have negative consequences on their health, social life and family responsibilities. While public hospitals often maintain the view that minimal budget flexibility restricts their capacity to affect change in a positive way, in fact devisable productivity and efficiency gains can be achieved by reducing working hours. Further, the medical profession needs to consider whether long hours provide an optimal environment for quality learning and performance.

Prevalence of stress in junior doctors during their internship training: a cross-sectional study of three Saudi medical colleges’ hospitals

“…International efforts to decrease stress and improve job satisfaction among interns have been made, such as reducing working hours, increasing workplace flexibility, and providing career advice and educational resources. 57 , 58 …”

Sleep Deprivation in Junior Doctors-House Officers in Singapore

“…This is important both for optimal patient care as house officers are the first line in provision of patient care and for healthy working lifestyle for the doctors' themselves 10) . The rising trend of post-call SSS scores (indicating increased sleepiness levels) as the post-call day wore on suggests that restricting the number of post-call hours might be an effective strategy.…”

Changing the health‐care workforce

“…This argument is laudable and fits in with modern society's values. It might even reduce medico‐legal risk in some situations 17 . However, patient care models do not reflect this significant change in patient care.…”