Cape Times - Overworked junior doctors are calling for new regulations on their working hours following the death of a young intern who was killed in a car crash after she allegedly fell asleep behind the wheel after working a very long shift.
Young doctors are blaming the Western Cape Department of Health and the Health Professions Council of SA (HPCSA) for allowing interns to work shifts of up to 30 hours or even longer.
The matter was raised by a concerned citizen and member of the medical profession, Dr John Roos, who wrote a letter to the Cape Times to highlight doctors’ concerns.
In the letter Roos used the tragic death of 25-year-old Paarl Hospital intern Ilne Markwat to throw the spotlight on the long hours doctors work.
Markwat was driving towards Cape Town on the N1 near Klapmuts at 10am on Friday last week when she fell asleep behind the wheel. Her vehicle crashed into the barrier before rolling and colliding with two other vehicles in the oncoming lane.
The young doctor succumbed to her injuries en route to Milnerton Mediclinic.
Markwat, who lived in Durbanville, started her medical internship at Paarl Hospital in January. She worked in the obstetrics unit, where last year interns had complained to the Junior Doctors’ Association of SA (Judasa) about working long shifts.
Markwat’s sister Tarien decline to comment on Monday.
“I wish to express grave concern for the safety and well-being of our junior doctors, and their patients. Junior doctors in the State Sector regularly work in excess of 30 hours per shift, sometimes without a break,” Roos wrote.
Roos said he had done extensive research on the consequences of working long hours.
“There seems to be a failure on behalf of the government to take cognisance of the consequences related to medical doctors who work overtime. We know of doctors who make serious mistakes while working long hours,” Roos said.
Earlier this year, Safe Working Hours, a group of local doctors campaigning to reduce the hours doctors have to work, petitioned HPCSA for a limit of 24 hours a shift.
Judasa chairperson Zahid Badroodien said junior doctors were currently expected to work 40 normal working hours and then 60 to 80 hours of overtime a month – equating to over 300 hours of work a month.
Badroodien said it was common for junior doctors to work continuously for more than 36 hours. “This results in an increase in medical errors which can lead to poor patient management. This is dangerous to ourselves as well as our patients.”
He said young doctors were being bullied by senior medical staff who had the perception that “long slogs through the night are a rite of passage” and will make them better doctors.
“We are held to ransom by the threat of not being approved for completion of the specific rotations…,” he said.
Badroodien said Judasa called for a cap of 24 hours and for the national department to review its overtime policy.
HPCSA spokesperson Fezile Sifunda said: “It is imperative that the contractual relationship between doctor and employer is consistent with the Basic Conditions of Employment Act and Conditions of Service that are applicable in the public sector.”
Sifunda said questions about overtime should be directed to the National Department of Health.
Department spokesperson Joe Maila referred the Cape Times to the Western Cape Department of Health. Western Cape Department of Health spokesperson Mark van der Heever admitted that medical interns worked for up to 30 hours in accordance with the provincial department and HPCSA’s policies.
“Interns should not exceed 30 hours of continuous work,” Van der Heever said.
Hospitals in the province monitored the working hours of interns within the policy parameters. “There will always be isolated incidents when hours will be temporarily extended due to the demands of service delivery, but this should not become a regular practice.”