Working 24/7: BHU Neurosurgery resident doctors allege toxic work culture, patient safety risks
Varanasi: A controversy has erupted over the working conditions of doctors and patient safety after resident doctors of the Department of Neurosurgery at Banaras Hindu University (BHU) raised serious allegations of extreme workload, toxic work culture, systematic exploitation, understaffing and compromised patient safety.
In a detailed note that went viral on social media, the resident doctors exposed the working culture at the prestigious health institution. The doctors described the situation at the institution as "systemic exploitation" that is not only affecting doctors but also putting patient safety at risk.
The residents claimed that they are working nearly 24/7 without rest, which has ultimately reached a point where patients' lives are being compromised. They stated that they are forced to hand-write treatment charts for over 100 patients daily, despite being awake for the last 18 hours, which, according to them, has resulted in medical errors.
The doctors claimed that ideally, a treatment chart prepared by a single doctor should be followed for four to five days and formally revised every five days, although minor edits can be made at any time if required.
Another concern raised by the residents is understaffing. They alleged that because much of their time is spent on non-medical clerical duties, they are sometimes unable to give critically ill patients the immediate attention and care they require.
They also raised concerns about what they described as a “shadow OT list.” According to the allegations, 10 to 15 elective surgeries are listed daily, requiring hours of preparation including pre-anaesthesia check-ups, consent forms and clearances, mostly handled by senior residents. However, by afternoon, many of these surgeries are reportedly cancelled, leading to unnecessary exhaustion.
"Initially, we thought this was done by consultants overenthusiastically, but gradually we realised this is not done for patient care; it is a tactic used to keep junior residents in a state of perpetual, unnecessary exhaustion," said the residents in the note.
Allegation of Toxic Work Culture, Non-Medical Duties Pushed on Residents
The resident doctors have further alleged that the hierarchy at the Trauma Centre and the Neurosurgery department has created a toxic environment where "nursing staff" and administrative roles are pushed onto them. These include drawing blood samples and completing Ayushman Bharat insurance paperwork.
"Residents are forced to act as phlebotomists (taking blood samples) and clerks (activating Ayushman Bharat paperwork). These are the duties of nursing and administrative staff, yet residents are threatened into doing them. The work of nursing and administrative staff is done by residents of each and every department. Nursing and administrative staff are doing minimal here, and this is normalised by hospital managements," the doctors said.
Another concern of the doctors is the unscheduled and continuous rounds by consultants stretching from 10 AM to 6 PM, followed by night rounds at 8 PM. They claimed that different consultants visit and reportedly give different treatment instructions to the residents for each patient, and the instructions change over time depending on the consultant.
"Each one comes at their own time and gives different orders for each patient. Residents have to follow each order and work accordingly, only to change treatment again by the next consultant's orders. This leaves zero time for anything else," the doctors added.
This culture of fear and "toxic seniority" is spearheaded by the leadership at the Trauma Centre and specific consultants who prioritise "keeping juniors busy" over the health of the residents and the safety of the patients, said the residents.
Frustrated with the work pressure, the residents stated that the current situation at the institution is the breaking point for neurosurgery. They claimed that they entered the prestigious institution with a dream to save lives, but are now exposing a system that is designed to break doctors and, consequently, kill patients.
They asked, "We are not asking for an easy life; we are asking for a functional one. We ask the public, the media, and others: How can a doctor who is tortured by consultants and hospital management work safely and effectively work?
Demands Raised
Unable to tolerate the alleged toxic work culture anymore, the resident doctors made a few demands, which include human behaviour with residents, proper delegation of duties so that nursing and clerical staff perform their assigned roles, an end to the intentional "scare tactics" and toxicity used by consultants and management, and appointment of additional staff.
The doctors further questioned that "If the residents are always in fear, doing 24x7 surgery for continuous one week, and under threat of consultants, how can they expect a good workflow, surgery and patient care in the department?
