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June 20 2021 6:54 AM ˚

Campaign calls for end to ‘abusive’ unpaid medical residencies

مستشفى الزرقاء الحكومي الغد Zarqa government hospital
Medics are seen at government hospital in Zarqa in this undated photo. (Photo: Jordan News)
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AMMAN — Resident doctors are on the frontlines of hospitals: having finished their formal medical education, they examine patients, diagnose conditions, and assist in surgeries. But in some hospitals in Jordan, they aren’t paid for their work. They’re trying to change that.اضافة اعلان

Medical residents in Jordan have started a social media campaign calling for an end to the unpaid residency program. They’re using the hashtags “my salary, my right,” “doctors not slaves,” and “you left us” to call for a change in the working conditions that they say endanger patients and drive qualified doctors out of the country.

Residents have completed six years of medical training and a low-paid internship year before they apply for a five to six year residency position in a certain specialty, according to Abdullah Nimer, a senior medical student at the University of Jordan who previously authored a study on burnout among residents. “Residency means that you work as a doctor,” he told Jordan News. “You’re working with the specialist. ... He needs you to manage his patients, to give medication, to help him in operations, to do clinics.”

He explained that universities in Jordan benefit financially from enrolling a high number of medical students — which results in a surplus of medical graduates with not enough paid resident seats. “The seats are very limited,” he said. There is a “huge supply and no demand for graduates.” Hospitals then argue that residents receive training, and are thus trainees, not employees. He pointed out that many of the residents who take unpaid seats have to take on side jobs, in addition to working up to 100 hours per week.

“Hospitals actually depend on residents more than they depend on consultants and specialists,” Nimer said. “The first one you see in the ER is a resident, and the one who discharges you is a resident.”

“For me personally, I do not feel I will get any job security under a medical system that doesn’t pay residents well,” he added. “I don’t think any patient should feel secure in hospitals that do not pay their residents.”

Riyad Sharqawi, general manager assistant at the Specialty Hospital in Amman, said that at his hospital, residents all receive a full salary alongside medical insurance. He criticized the unpaid system, saying “It’s very important to pay for this because they’re working,” he told Jordan News. “And usually they have hard work,” including being on-call multiple times a week and working up to 100 hours per week.

The unpaid residencies “must be stopped immediately,” said Ahmad Awad, director of the Phenix Center for Economics and Informatics Studies and Jordan Labor Watch, in an interview with Jordan News. “The private sector always, if there is no accountability for them, would like to increase their profits,” he said.

Fresh graduates, he explained, are eager to obtain specialties, which will make them more employable — so eager that they will accept unpaid positions so long as they receive that specialty training.

One of the organizers of the campaign, pediatric specialist Ghaith Abdallah Al-Aryan, estimated that around 20 to 30 percent of residents are unpaid. “They are manipulating the labor law, they are using it to say that these residents are trainees,” he told Jordan News. At the same time, the teaching hospitals that take on residents are granted tax exemptions, he said — which should allow for them to pay their residents.

He explained that in addition to pay, the campaign is calling for there to be a cutoff of the maximum hours residents can work per week (like the 80-hour limit implemented in the US), better treatment of residents by their superiors, and venues for residents to voice their complaints.

The working conditions also affect patients. “Burnout reflects on their care of their patients,” said Aryan. Previously, Jordan News reported that eight in ten medical residents in the Kingdom experience burnout, a state of continuous exhaustion that can lead to medical errors.

Maisam Akroush, a practicing physician and member of both the Jordanian Medical Association and Jordanian Medical Council, which is responsible for training interns and residents, described the practice as “unethical, immoral, and will be reflected by the service given by these doctors.”

She pointed out that some residents will be nearing the age of 30 and are still unpaid, which may prevent them from taking other steps in their lives like starting a family.

She called for the council to refuse to recognize hospitals unless they guarantee a certain number of paid doctors for each number of beds in each specialty.

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