Even with a 52-hour workweek limit, residents often work 80 hours... "Measures must be taken"

Resident

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There are growing calls to establish measures to reduce the working hours of residents, who commonly work more than 80 hours per week. To prevent overwork among residents, the ‘Special Act on Residents’ was implemented in 2017, allowing work up to 80 hours per week, but this is still much longer compared to the government’s proposed labor hour reform plan (maximum 69 hours per week), and frontline hospitals often fail to comply due to reasons such as medical staff shortages.

Professor Kim Hyung-ryeol of the Department of Occupational and Environmental Medicine at The Catholic University emphasized at the ‘2030 Residents’ Roundtable’ held at the National Assembly on the 17th that “since residents are also workers, it is necessary to reduce working hours to secure their right to health.” Professor Kim pointed out that “a comprehensive review of studies conducted in the United States, Canada, Germany, Australia, and South Korea shows that compared to an 8-hour workday, the risk of accidents increases by 15% and 38% when working 10 and 12 hours, respectively.” He also added, “If working hours exceed 12 hours, the risk surges by 147%.”

According to the ‘2022 Residents’ Survey’ released by the Korean Intern Resident Association, the average weekly working hours of all residents was 77.7 hours. Residents working 15.5 hours per day on a 5-day week basis fall into the ‘high-risk group for accidents.’ The daily working hours of residents in specialties suffering from chronic manpower shortages, such as thoracic surgery (102.1 hours), surgery (90.6 hours), and neurosurgery (90.0 hours), are even more severe.

Professor Kim stated, “The Special Act on Residents, which caps the maximum weekly working hours at 80, has indeed contributed to reducing residents’ working hours,” but he also noted, “Conversely, this law has prevented further reductions in working hours.” Regarding why working hours have not decreased further, he explained that it is due to “complex factors” such as physician supply shortages and operational difficulties of training hospitals caused by low insurance fees. To address this, countries like the United States, Canada, Japan, and Europe partially cover the training costs of residents, and Professor Kim said, “There needs to be discussion so that South Korea can move in this direction.” Professor Kim Sang-geol of Kyungpook National University’s Department of Surgery advised, “If the fees for essential medical services increase, hospitals will have more operational leeway, which will naturally improve the training environment for residents.”

There were also suggestions to limit the number of patients per resident to around 15. According to a survey conducted by the Korean Intern Resident Association targeting residents in December last year, 16.0% and 4.4% of respondents said that the number of patients they are responsible for as attending physicians during regular working hours is between 21?30 and 31?40, respectively. This means that one in four residents cares for at least 21 inpatients. Kang Min-gu, president of the Korean Intern Resident Association, said, “During night shifts, residents sometimes care for over 100 patients, which inevitably poses a threat to patient safety.”

However, there were also recommendations to consider the ‘balloon effect,’ where improving the training environment for residents leads to increased workloads for other medical personnel such as fellows and professors.

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