TY - JOUR
T1 - Medical residency in Portugal
T2 - a cross-sectional study on the working conditions
AU - Chen-Xu, José
AU - Miranda Castilho, Bruno
AU - Moura Fernandes, Bruno
AU - Silva Gonçalves, Diana
AU - Ferreira, André
AU - Gonçalves, Ana Catarina
AU - Ferreira Vieira, Maycoll
AU - Silva, Andreia M.
AU - Borges, Fábio
AU - Paes Mamede, Mónica
N1 - Funding Information:
This research received a grant from the Independent Union of Portuguese Doctors (Sindicato Independente dos Médicos, number 2023/7425). The funder provided support with data collection by disseminating the questionnaire to resident doctors within their internal mailing lists, with no other role in study design, data analysis, decision to publish, or preparation of the manuscript. No other funding agency from the public, commercial or not-for-profit sectors financially contributed to this research. Acknowledgments
Publisher Copyright:
2023 Chen-Xu, Miranda Castilho, Moura Fernandes, Silva Gonçalves, Ferreira, Gonçalves, Ferreira Vieira, Silva, Borges and Paes Mamede.
PY - 2023
Y1 - 2023
N2 - Objectives: The current European crisis in human resources in health has opened the debate about working conditions and fair wages. This is the case with Resident doctors, which have faced challenges throughout Europe. In Portugal, they account for about a third of the doctors in the Portuguese National Health Service. No studies to date objectively demonstrate the working conditions and responsibilities undertaken. This study aims to quantify the residents' workload and working conditions. Methods: Observational, retrospective cross-sectional study which involved a survey on the clinical and training activity of Portuguese residents, actively working in September 2020. The survey was distributed through e-mail to residents' representatives and directly to those affiliated with the Independent Union of Portuguese Doctors. The descriptive analysis assessed current workload, and logistic regression models analyzed associations with geographical location and residency seniority. Results: There were a total of 2,012 participants (19.6% of invited residents). Of the residents giving consultations, 85.3% do so with full autonomy. In the emergency department, 32.1% of the residents work 24 h shifts and 25.1% work shifts without a specialist doctor present. Regarding medical training, 40.8% invest over EUR 1,500 annually. Autonomy in consultations was associated with being a Family Medicine resident (OR 4.219, p < 0.001), being a senior resident (OR 5.143, p < 0.001), and working in the Center (OR 1.685, p = 0.009) and South regions (OR 2.172, p < 0.001). Seniority was also associated with investing over EUR 1,500 in training annually (OR 1.235, p = 0.021). Conclusion: Residents work far more than the contracted 40 h week, often on an unpaid basis. They present a high degree of autonomy in their practice, make a very significant personal and financial investment in medical training, with almost no time dedicated to studying during working hours. There is a need to provide better working conditions for health professionals, including residents, for the sake of the sustainability of health systems across Europe.
AB - Objectives: The current European crisis in human resources in health has opened the debate about working conditions and fair wages. This is the case with Resident doctors, which have faced challenges throughout Europe. In Portugal, they account for about a third of the doctors in the Portuguese National Health Service. No studies to date objectively demonstrate the working conditions and responsibilities undertaken. This study aims to quantify the residents' workload and working conditions. Methods: Observational, retrospective cross-sectional study which involved a survey on the clinical and training activity of Portuguese residents, actively working in September 2020. The survey was distributed through e-mail to residents' representatives and directly to those affiliated with the Independent Union of Portuguese Doctors. The descriptive analysis assessed current workload, and logistic regression models analyzed associations with geographical location and residency seniority. Results: There were a total of 2,012 participants (19.6% of invited residents). Of the residents giving consultations, 85.3% do so with full autonomy. In the emergency department, 32.1% of the residents work 24 h shifts and 25.1% work shifts without a specialist doctor present. Regarding medical training, 40.8% invest over EUR 1,500 annually. Autonomy in consultations was associated with being a Family Medicine resident (OR 4.219, p < 0.001), being a senior resident (OR 5.143, p < 0.001), and working in the Center (OR 1.685, p = 0.009) and South regions (OR 2.172, p < 0.001). Seniority was also associated with investing over EUR 1,500 in training annually (OR 1.235, p = 0.021). Conclusion: Residents work far more than the contracted 40 h week, often on an unpaid basis. They present a high degree of autonomy in their practice, make a very significant personal and financial investment in medical training, with almost no time dedicated to studying during working hours. There is a need to provide better working conditions for health professionals, including residents, for the sake of the sustainability of health systems across Europe.
KW - health economics
KW - health policy
KW - healthcare workers
KW - medical education
KW - residency
KW - training
UR - http://www.scopus.com/inward/record.url?scp=85183660274&partnerID=8YFLogxK
U2 - 10.3389/frhs.2023.1190357
DO - 10.3389/frhs.2023.1190357
M3 - Article
C2 - 38116534
AN - SCOPUS:85183660274
SN - 2813-0146
VL - 3
JO - Frontiers in Health Services
JF - Frontiers in Health Services
M1 - 1190357
ER -
