Cape Town - One month, 163 hours overtime, and a needlestick injury.
This first-year intern at Groote Schuur Hospital wrote to the Cape Argus to express her frustration.
In terms of her contract with the Health Department, she cannot be named.
“We were told that Groote Schuur cut intern posts from 61 to 37 new interns for 2014, hence our working hours are absurd,” she said.
Another Groote Schuur intern in his second year took to the Safe Working Hours for Junior Doctors petition on Change.org to air his views.
“Just my overtime for this month tallies at 187 hours,” he wrote. “It’s abusive, illegal and most certainly detrimental to doctors and patients!”
But Alaric Jacobs, spokesman for Groote Schuur, said no intern reduction had taken place.
“The number of interns has not been reduced and has remained stable,” he said. “If an intern indeed worked 160 hours in a single month this would be contrary to departmental policy and should be brought to the attention of the hospital management.”
The first-year intern said she tallied up her hours over four months in the surgical rotation. According to her contract, she should have worked 320 hours overtime altogether – 80 each month. Instead, she clocked up 434 hours.
To top that, she sustained a needlestick injury and had to suffer the side effects of antiretrovirals.
One night, she stood in the operating theatre from 1am to 7am battling nausea while assisting with a burst appendix. A senior doctor had to take her aside and tell her to rest because she looked like she was about to collapse.
Her record is 22 hours and 30 minutes on her feet without a break.
“I was very keen to work in the public sector before I had to work like this,” she said. “Now I feel I will be much better off in the private sector.”
She said some of the other interns were ready to leave medicine altogether.
“On my last Sunday call, I just completely broke down. I could not function any more. I couldn’t even lead a healthy lifestyle.”
Her work has consumed her hopes of starting a family: “I’m married and I would love to have had a kid by now, but it’s not going to happen.”
She has finished her surgical rotation and moved on to paediatrics. She said Groote Schuur had responded by organising meetings and arranging for an extra intern.
Spokeswoman Charmaine Motloung said the HPCSA stipulated guidelines about maximum overtime hours interns should work, but it was up to employers to ensure a safe workplace.
“Interns must not be viewed as service providers and cover for a shortage of doctors in a facility. (They) are, however, encouraged to use the learning opportunities at hand which might require extra time to be put in.”
The HPCSA requires health professionals to report themselves or their colleagues if they are “impaired”, but Motloung said fatigue did not count as impairment.
“It is the responsibility of the intern to inform his supervisor if he feels that his health status will pose a risk to the patient, whether through physical illness or exhaustion.
“Practitioners who are fatigued would be affected when required to make judgement calls and would, therefore, be at the risk of making clinical errors.”
The HPCSA undertakes to monitor hospitals accredited to offer internship training. It conducts an evaluation every two years of most facilities, and every year for hospitals with “challenges”.
The internship training sub-committee had received complaints about excessive working hours.
Health Department spokesman Joe Maila said the overstretched health care system was not unique to South Africa.
“The world has a shortage of doctors, not only in South Africa. We lack something like four million health professionals in the whole world.”