No more punishment shifts for medical residents; Congress revives legal debate

“On October 1st I had to sleep on the stairs because we don’t have a place to rest”; “sleeping 30 minutes in two days is not human”; “Punishment guards out.” The complaints of the unworthy working conditions suffered by the medical staff in training they are always latent and we only stop to see them every time something more serious happens to them.

The way they unfold the medical guards in Mexico “it violates international standards, as well as the Constitution,” says federal deputy Mary Carmen Bernal Martínez (PT), who presented an initiative to reform the General Health Law so that undergraduate and postgraduate guards specialization residences are not excessive and are remunerated.

But first, let’s explain what happened so that these complaints were exposed publicly again. On Tuesday, October 18, Fernando Villalobos, an undergraduate medical intern (MIP), was accused of theft of material by authorities at the Hospital 1º de Octubre of the Institute of Security and Social Services for State Workers (ISSSTE).

Immediately, her companions and companions demanded her release and an improvement to the general conditions where they do their work. The young man was detained in an agency of the Public Ministry until Friday the 21st, when he was released with the help of his family. However, the charges have not been dropped and the situation for the rest remains the same.

So on Sunday, October 23, within the framework of the doctor’s daycalled a national strike of MIP and in the hospital that accused Fernando they hung a clothesline with testimonies and complaints about his conditions. In addition, on Monday the 24th they marched from the Plaza de las Tres Culturas to the 1st of October.

“36 hours on duty, 48 hours in the MP. #JusticiaParaFer”, “We take care of your health at the expense of ours. We don’t eat, we don’t sleep and they also treat us like criminals”, were some of the phrases that were seen in the protest.

A day (or three) in the life of a resident

Las resident medical guards are regulated in the official Mexican standard NOM-001-SSA3-2012, Education in Health, which indicates that those who attend a residency “must be available when their services are required during shifts. When this is not the case, they may use the rest areas for resident doctors with the authorization of the person in charge of the service”.

They must be scheduled in the operating program, they will only be three times per week maximum and will have intervals of at least two days between each of them. “On business days, shifts start at the time the morning shift ends and end at the time set to start the next morning shift.” But on weekends and holidays it lasts 24 hours.

However, in practice, medical shifts have developed in a different way, says deputy Mary Carmen Bernal in the statement of reasons for her reform proposal, and they last 36 hours on holidays. Business days start from 6:00 a.m. to 7:00 a.m. or from 7:00 a.m. to 8:00 a.m., ending at 3:00 p.m. the next day, that is, 32 consecutive hours.

In addition, they have classes every day and once a week they review academic articles and clinical cases. “It is done delivery guard (findings, incidents that have occurred, accusing complaints from residents of lower and/or higher rank, in addition, a list of all productivity carried out is delivered)”.

The time for your breakfast It is generally between 7:30 and 8:30 a.m., but “regularly it is not done because in each service it is the visit to the sick and handover. In the surgical area (surgeons and anesthesiologists) at 8:00, surgery begins.

There is no fixed time for lunch and dinner is from 7:30 p.m. to 8:00 p.m. “The quality of the food is poor, high in calories, high in carbohydrates and low in protein.”

The legislator informs that “in all the medical residencies there are ‘punishments’ for implausible faults”, such as going to the dining room to eat your food. “The favorite punishment is to leave the residents of lower grades punished for a whole weekend (Friday, Saturday, and Sunday), leaving on Monday, but if they have their normal guard, they would leave until Wednesday,” he points out. the legislator.

Not all medical residences have rest areas or showers, he details. All this violates international standards and the Constitution, he says, “the International Labor Organization (ILO), in the 1919 Convention, limited work in the industry to eight hours a day and a maximum of forty-eight hours per week”.

For this reason, it proposes adding a third paragraph to article 95 of the General Health Law, which would indicate that: “The shifts carried out during the undergraduate internship and the specialization residencies they must not have a longer working day than that permitted by law, unless the service so requires; nor should they be inhumane, excessive or dangerous, they will be remunerated and will enjoy the other benefits of the law.

The young men and women who are being subjected to such brutal guards have various health problems, both physically and mentally, stresses the deputy. It is urgent to change this situation, she points out.