Doctors' burnout due to 24-36 hour shifts! Parliamentary panel calls for Clinical Duty hour regulation policy with mandatory rest, monitored rosters

New Delhi: Taking note of the huge vacancies in the posts of faculty members and residents at the central government medical institutes, a Parliamentary Committee on Health has expressed concern about the excessive workload of doctors.

Highlighting the possibility of clinical errors and burnout resulting in compromised patient safety, the panel has recommended formulating and strictly enforcing a "Clinical Duty Hours Regulation" policy with mandatory rest periods and monitored rosters.

These recommendations were presented before the Parliament by the Department-related Parliamentary Committee on Health and Family Welfare in its 172nd report.

Huge Vacancies in Faculty Positions and workload: 

In the report, the Health Panel, headed by Samajwadi Party leader and Rajya Sabha member Ram Gopal Yadav, has expressed concern regarding the huge shortage of staff, especially teaching faculty at premier medical institutes like AIIMS Delhi, Vardhman Mahavir Medical College (VMMC), Lady Hardinge Medical College (LHMC), Atal Bihari Vajpayee Institute of Medical Sciences (ABVIMS) etc.

The committee recorded that around 37.75 per cent of faculty and 31.52 per cent non-faculty positions were vacant across the new and established AIIMS institutes across the country.

In the case of LHMC, New Delhi, the report revealed that out of a sanctioned strength of 2,225 posts, 652 posts (nearly 29%) remain vacant in the institution, with particularly alarming shortages in critical and supervisory categories such as Tutors in the College of Nursing (91% vacancy), Administrative Officer (100%), Radiotherapy Technologist (100%), OT Technicians and related cadres (70–80%), Nursing Officers (31%), and Doctors in the Teaching Cadre (21%).

"Such extensive vacancies, especially in teaching, nursing, and technical posts directly linked to patient care and academic delivery, are likely to adversely affect hospital efficiency, quality of clinical services, research productivity, and faculty workload," the panel observed in its report.

Regarding ABVIMS, the panel noted in the report that there is a vacancy of 47.4% among senior residents. 

Non-joining of residents at VMMC: 

The committee was informed that in the year 2023, a total of 41 candidates for the posts of Senior Residents did not join the institute out of the 305 selected candidates. In the year 2024, the recruitment was delayed and shifted to year 2025. In 2025, two recruitments were done, and a total of 52 out of 376 Candidates did not join in the first recruitment, whereas the second recruitment is currently ongoing.

In the report, the panel noted that the candidates who did not join the institute cited reasons for not joining the institute, such as selection in other institutions of choice, preparation for super speciality courses, excessive workloads, and opportunities abroad with better emoluments. The committee estimated that a large percentage of resignations is due to working conditions, pay scales, or career progression issues.

Committee Expresses Concern over Burnout Risks of Resident Doctors:

Referring to extensive vacancies, especially in teaching, nursing, and technical posts, the committee opined that such vacancies are directly linked to patient care and academic delivery, are likely to adversely affect hospital efficiency, quality of clinical services, research productivity, and faculty workload.

It noted that persistent human resource shortages, coupled with unregulated and alarmingly prolonged working hours of Junior and Senior Residents, sometimes stretching up to 24-36 hours, pose serious risks to both healthcare providers and patients.

According to the panel, excessive continuous duty hours for Junior and Senior Residents result in a risk of clinical errors and burnout, thereby compromising patient safety.

Therefore, the committee has recommended implementing a mandatory working-hour regulatory framework for Resident Doctors to minimize fatigue-induced clinical errors and to safeguard their mental and physical well-being, drawing an analogy from regulated working-hour norms in other critical sectors such as fatigue management protocols used for commercial pilots in civil aviation.

"The Committee, therefore, recommends that the Department formulate and strictly enforce a "Clinical Duty Hours Regulation" policy with mandatory rest periods, and monitored rosters, drawing a direct analogy from other safety-critical professions like civil aviation to prevent fatigue-induced accidents," it recommended.

"The presence of senior faculty should be ensured in wards and in operating theatres during peak hours by aligning faculty schedules with clinical demand and by appointing designated supervisory rosters. Structured mentorship and protected teaching time should be introduced so that trainees gain supervised clinical experience rather than learning by trial. Additionally, to ensure the retention of high-quality talent, the Committee recommends that medical professionals be provided with improved working conditions, including accommodation, transportation, and administrative support, on par with the facilities afforded to senior civil servants, and transparent career progression with time-bound promotions. The Committee also suggests the integration of Yoga and the Indian Knowledge System (IKS) within the workforce to address the rising incidence of depression and psychiatric issues among the medical community," the panel further suggested in the report.

How to Retain Doctors? Committee's Recommendations:

Meanwhile, addressing the issue of vacancies, the committee has suggested several measures to retain doctors at the medical institutes to tackle the workload. It recommended adopting a time-bound, mission-mode approach to clear all pending vacancies, including those on hold due to court cases, non-finalisation of Recruitment Rules, or absence of feeder cadres. Apart from this, the panel also recommended strengthening the manpower availability by instituting an independent study so that recruitment of specialist doctors is done on a larger scale to provide adequate health support to the patients and to prevent backlog and overcrowding.

Additionally, the panel also recommended other measures such as improving the working conditions, including adequate accommodation, transport facilities, career progression avenues, and structured leadership opportunities for doctors with managerial qualifications, to retain and motivate doctors.

"The Committee further observes that faculty members are currently burdened with excessive academic, clinical, examination, and research responsibilities due to vacant teaching posts, even though the student-teacher ratio may formally meet regulatory norms. Given the substantial clinical workload and implementation of multiple national health programmes, the Department should ensure expeditious filling of teaching cadre posts and strengthen supportive administrative structures to enable faculty to focus on academic excellence and patient care. In addition, improved working conditions, including adequate accommodation, transport facilities, career progression avenues, and structured leadership opportunities for doctors with managerial qualifications, may be considered to enhance retention and motivation," it observed.

Regarding the high rate of non-joining and frequent resignations among medical professionals, the committee has recommended that the Department must transition from simple recruitment to a holistic retention strategy. It recommended beginning a data-driven "Exit and Non-Joiner Survey" to precisely identify why candidates prefer other institutes or opportunities abroad. 

For specialized technical cadres currently facing up to 100% vacancy, the Department should introduce "Targeted Lateral Entry" and clear career progression pathways.

While the committee has opined that contractual engagement may be used as a short-term stop-gap arrangement, it has also opined that it should not substitute regular appointments, as excessive reliance on contractual staff may dilute institutional accountability and continuity.

Instead, the panel has recommended adopting a "Total Support model for medical professionals" to attract and and retain qualified doctors and specialists in the public health system.

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