Facing threats, medical residents at Rambam hospital withdraw resignation letters

Medical residents at the Rambam Medical Center in Haifa have withdrawn their letters of resignation amid an ongoing dispute over long hospital shifts and threats by the hospital chief that they would be fired if they didn’t do so.

Last week, 200 medical residents across the country submitted their letters of resignation due to a long-running dispute with the Health Ministry over lengthy shift hours. The resignations only take effect two weeks after the letters are handed to an employer, giving the Health Ministry a further 14 days to try and prevent the mass exodus of trainee doctors.

The hospital said Wednesday that all 25 medical residents who had submitted resignation letters retracted them, two days after Rambam’s director, Michael Halberthal, reportedly threatened to sack them.

Halberthal welcomed the retractions and said he would work to help find “a solution to the issue of the shifts and continue working on the frontlines to improve working conditions for hospital staff and to advance public health,” according to Ynet.

On Sunday, Halberthal called a meeting with the residents to warn them that they had two days to retract their letters or he will fire them himself, according to a Channel 12 report.

He also told them that even if a proposed framework to reduce shift hours is put into practice next year, it will take some time until it can be applied in the hospital.

Some of the residents were said to have left the meeting in tears.

Trainee doctors are currently required to work 26-hour shifts, but have been lobbying for that to be decreased to 16-18 hours, claiming that their inability to concentrate for such an extended period of time without rest endangers both the medical professionals and patients.

While the government had originally agreed to shorten shifts by April this year, a July announcement said that the change would be pushed off until September 2023, citing procedural problems caused by the upcoming elections.

The Mirsham organization, which represents medical residents in Israel, said in a press conference last Thursday that around 200 residents were submitting resignation letters in a first round, with many more to come if the crisis is not resolved.

Economy Minister Orna Barbivai told Ynet on Sunday that she backs doctors’ demands to reduce their hours — which is why she approved the new framework — but she has no choice but to delay it because of the November 1 elections. Barbivai noted that the attorney-general also said it will not be possible to make the necessary changes in regulations during the election period.

Implementing the framework will require approving more doctor positions nationwide — something requiring changes in regulations that can’t be made while the Knesset is in recess.

Jonathan Halevy, president of the Shaare Zedek Medical Center in Jerusalem, told Radio 103FM on Sunday that everyone agrees the shifts need to be shortened and that working 26 hours “is completely unacceptable.”

However, he claimed that while the Mirsham organization has around 1,000 members, there are another 7,500 residents in the Israel Medical Association who support a plan to begin shortening shifts first in periphery medical centers, and only starting next year.

Halevy pointed out that in order to shorten doctors’ shifts, hundreds more positions must be opened in hospitals, and staff hired to fill them, all of which takes time, making it impossible to shorten shifts as quickly as the residents are demanding.

In addition, he said that those who choose to become doctors in hospitals or surgeons know that they will be required to work the long shifts to get where they want to be.

“For many years that is how doctors were qualified,” he noted.

Health Minister Nitzan Horowitz has backed the protesting residents and placed the blame squarely on the Finance Ministry, saying “the Health Ministry supports the shortening of shifts” and insisting that the “budget is in place” to do so.

Last October, thousands of residents resigned in protest of the 26-hour shifts they are expected to work. The government then proposed a plan under which the shifts at 10 hospitals in outlying areas, outside the center of the country, would be shortened to 16-18 hours. It was to begin on April 1.

Until 2000, residents worked 36-hour shifts and sometimes more. That year, an agreement was signed to reduce the shifts to 26 hours with a two-hour break.

In 2012, following appeals to reduce the hours again, the government limited residents to two shifts a week, and said they could not work more than 71.5 hours in a week. But despite the new regulations, most hospitals have not implemented them.