Plan to slash medical residents’ 26-hour shifts delayed until September 2023

Burden of 26-hour shifts drove thousands of trainee doctors to threaten resignation last year; promised change to 18 hours was never implemented

Medical residents demonstrate for better work conditions in Tel Aviv, October 9, 2021. (Tomer Neuberg/Flash90)
Medical residents demonstrate for better work conditions in Tel Aviv, October 9, 2021. (Tomer Neuberg/Flash90)

A plan to gradually begin shortening hospital shifts for medical residents from 26 hours to 18 hours has been delayed until September 2023, the government announced on Sunday.

The plan to gradually shorten shifts was supposed to take effect earlier this year starting with a pilot program in 10 hospitals in the so-called periphery, outside Israel’s central cities. This followed threats of mass resignations last year by thousands of medical interns in protest of the long shifts. The protesters had warned at the time that the proposed government plan was announced, in October 2021, that it was too vague and had no clear rollout.

The announcement on Sunday came in a response to a Labor Court petition filed in April by the Clalit Health Services HMO that said there was not enough manpower to absorb a cut in intern hours and as a result, public health would be affected, Maariv reported. The petition was filed against the Health Ministry and the ministers of health and the economy.

In response, Economy Minister Oran Barbivai said on behalf of the government that the matter could only be resolved by the next Knesset following elections in November, according to Hebrew-language media reports.

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 would be shortened to 16-18 hours. It was to begin on April 1.

In its petition, Clalit claimed another 300 doctor positions would be needed to cover the shortfall if residents’ hours were cut.

In addition, hospitals in the periphery said they did not have enough staff to fill the shifts and the Finance Ministry refused to budget new doctor positions, according to the report.

Residents in more central hospitals also rejected the plan, demanding that shifts at their places of work also be reduced.

A follow-up report by the Health Ministry suggested cutting shifts in the periphery and at some central hospitals to 21 hours, a proposal the interns backed.

In the meantime, no changes to shifts were made.

After the state announced the postponement until next year, the interns’ organization, Mirsham, said in a statement that Barbivai had “given in” to pressure and that the delay was a “death sentence” to reducing the shifts.

“Despite… the pompous announcements in the media the residents have been left with nothing,” Mirsham said, accusing the government of pushing to keep the shift cuts only in periphery medical centers as an incentive for those areas.

“We call on the prime minister to take responsibility and change this miserable decision,” it said.

Last year the government had promised that after the pilot program in the 10 outlying hospitals, the plan would expand to all hospitals if the required budget could be found and if a committee set up to examine the issue could establish that the level of medical care was not compromised.

Up until the year 2000, interns 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 adjusted the irregular work permit to limit interns to two shifts a week, and for them to not work more than 71.5 hours in a week.

Despite the new regulations, most hospitals have not implemented them.

According to a 2016 poll published in The Marker, 72% of medical residents worked more than 26 hours in a row at least once a month, 42% didn’t sleep during their shift, and 27% worked more than 71.5 hours a week.

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