Long, multiple 24-hour duties leading cause of mental health issues among PG medicos: NMC tells Supreme Court
New Delhi: A long, round-the-clock duty roster is one of the leading causes of mental health issues in postgraduate medical students across India, the National Medical Commission (NMC) told the Supreme Court.
Submitting its affidavit in response to the PIL demanding implementation of the 1992 Uniform Residency Scheme for resident doctors, NMC further added that even the National Task Force 2024, in its report, agreed that excessive duty hours posed risks to the physical and mental health of medical students and compromised patient safety.
The Apex Medical Commission referred to the Task Force's report, which mentioned, "The demanding schedules, including long and multiple 24-hour duties 1 (sometimes 3-5 consecutive duties), were significant stressors among the most PGs. These extended hours without adequate rest led to physical and mental exhaustion, negatively impacting their performance and health ..."
NMC pointed out that even though the 1992 Residency Scheme was issued to mitigate the effects of excessive duty hours, and advised that resident doctors should generally not exceed 12 hours of continuous active duty per day and 48 hours per week, those guidelines were not implemented due to a shortage of human resources and other logistical reasons.
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Meanwhile, NMC further referred to the Task Force's recommendation stating that, "...based on feasibility, resources, and relevance, that residents work no more than 74 hours per week, with no more than 24 hours at a stretch. This schedule includes one day off per week, one 24-hour duty, and 10-hour shifts for the remaining five days. It is also important for medical students to sleep at least 7-8 hours per day for optimal mental and physical health. Department Heads (HODs), faculty members, senior residents, and Junior Residents (JRs} can collaboratively plan duty hours and roster the duty, into three shifts, or two shifts, or one shift based on human resource availability. Additionally, strict adherence to the National Medical Commission (NMC) regulations for a weekly one-day off is crucial. Implementing these measures, where feasible, will help protect the health of medical students and improve patient safety. It is imperative to recognize that post-graduates and interns primarily serve educational purpose."
Medical Dialogues reported last year that the doctors under the United Doctors' Front (UDF) had filed a Public Interest Litigation (PIL) in the Supreme Court against the "inhumane working hours of resident doctors". The association has challenged the "exploitative and unconstitutional working conditions imposed on resident doctors across the country".
The plea, filed through Advocates Mr. Satyam Singh, and Ms. Neema AOR, sought urgent intervention from the Apex Court to enforce compliance with the Ministry of Health and Family Welfare's 1992 directive notification, which mandates that resident doctors should not work more than 12 hours per day and 48 hours per week.
The PIL highlighted that despite clear directives from the Supreme Court over three decades ago, medical institutions continue to violate prescribed standards. The petition cites the National Task Force report on Mental Health and Well-being of Medical Students, which documented over 150 suicides of medical students within five years, primarily due to work-related stress and sleep deprivation.
NMC had submitted before the Apex Court that it had already taken necessary steps to regulate working hours and improve the mental well-being of medical students and resident doctors.
Along with this, the commission informed the apex court that the state governments and medical institutions are responsible for the implementation of duty hours because NMC's primary role is to regulate medical education and academic standards under the National Medical Commission Act, 2019.
Also Read: Resident doctors' duty hours implementation lies with states: NMC tells Supreme Court
