AIIMS Sets 12-Hour Daily Duty Limit for Resident Doctors

AIIMS Sets 12-Hour Daily Duty Limit for Resident Doctors

In a landmark decision aimed at addressing the chronic issue of overwork and burnout among its junior medical staff, the All India Institute of Medical Sciences (AIIMS) in New Delhi has issued a new Office Memorandum (OM) capping the duty hours for its resident doctors. The new guidelines, which were officially issued on August 21, 2025, state that continuous active duty for a resident doctor should not normally exceed 12 hours per day. Furthermore, the OM specifies a maximum weekly workload of 48 hours for junior residents and mandates one weekly holiday on a rotational basis.

This move by AIIMS, one of the country's premier medical institutions, is being hailed by some as a progressive step towards safeguarding the mental and physical well-being of doctors. However, it has also sparked a debate within the medical community, with many resident doctors expressing skepticism about the feasibility of implementing such a rule given the existing severe shortage of manpower.

A Long-Standing Problem: The Reality of Resident Doctors' Lives

For years, the issue of inhumane working hours for resident doctors has been a major point of contention and a source of widespread discontent. The 1992 Central Residency Scheme, which was formulated in response to a Supreme Court directive, had a provision for resident doctors to work a maximum of 48 hours per week and no more than 12 hours at a stretch. However, this rule has largely remained on paper. In reality, resident doctors, particularly those in high-demand departments like surgery, medicine, and orthopedics, often find themselves working shifts that extend well beyond 36 hours without any break. Stories of residents fainting from exhaustion, suffering from sleep deprivation, and experiencing severe mental and physical health issues are a common occurrence.

The continuous cycle of long hours, combined with the immense pressure of handling life-and-death situations, takes a heavy toll. It not only affects the doctors' health but also raises serious concerns about patient safety. A tired and overworked doctor is more prone to making errors, which can have devastating consequences. The new OM from AIIMS is a direct response to this ongoing crisis, and it follows a Public Interest Litigation (PIL) filed in the Supreme Court by the United Doctors' Front (UDF), which has been advocating for the strict enforcement of the 1992 guidelines.

The New AIIMS OM: Key Directives

The new Office Memorandum issued by the AIIMS administration is a reiteration and a formal attempt to enforce the long-dormant guidelines. The key points of the OM are:

• Daily Limit: Continuous active duty for resident doctors will not normally exceed 12 hours per day.
• Weekly Limit: Junior residents are expected to work for a maximum of 48 hours per week.
• Weekly Off: All resident doctors will be granted one weekly holiday on a rotational basis.
• On-Call Duty: On-call duty should not exceed 12 hours at a time.
• Flexibility and Monitoring: The OM acknowledges that working hours will be flexible depending on the workload and the availability of doctors for clinical work. It also directs all Chiefs of Centers and Heads of Departments to maintain detailed records of duty hours and share them with the academic section as and when required.

The OM is a positive step on paper, as it gives the resident doctors a formal document to challenge exploitative working conditions. It provides a clear framework and a set of rules that can be used to hold departments accountable.

The Feasibility Challenge: A Manpower Crisis

While the new guidelines have been welcomed by some, their practical implementation is the subject of intense debate and skepticism. The primary concern, voiced by several resident doctors and medical associations, is the severe manpower shortage.

Dr. Sai Kaustubh, the president of the Resident Doctors' Association (RDA) at AIIMS Delhi, has been vocal about this issue. He has stated that while the new rules are a welcome move, they are simply not feasible with the current strength of residents. According to him, the same notice has been issued at least three times in the last six years, but little has changed on the ground. Departments, especially those with high patient footfall like orthopedics and obstetrics and gynecology, simply do not have enough residents to manage the workload within a 12-hour duty cap. A senior resident, speaking on the condition of anonymity, highlighted that they often work for 36 hours straight, a reality that is far from the 12-hour limit specified in the new OM.

The core of the problem lies in the student intake. The number of postgraduate seats and junior resident positions has not kept pace with the ever-increasing patient load. As a result, the existing residents are stretched thin, and a 12-hour duty limit would either lead to a breakdown in patient care or simply be ignored by the departments to ensure the hospital runs smoothly. For a rule to be truly effective, a substantial increase in the number of resident doctors is needed, a step that requires long-term planning and investment from the government.

The Path Forward: A Call for Systemic Reform

The new OM from AIIMS is a microcosm of a larger problem plaguing the Indian healthcare system. It highlights the need for a comprehensive and systemic reform that goes beyond issuing a simple memorandum. The steps that need to be taken to ensure the well-being of resident doctors and the quality of patient care are:

1. Increase Manpower: The most critical step is to increase the number of residency seats in medical colleges across the country. This will help reduce the burden on existing residents and make it possible to implement the duty hour caps.
2. Regular Audits: The National Medical Commission (NMC) and other regulatory bodies need to conduct regular, unscheduled audits of hospitals to ensure that the duty hour guidelines are being followed.
3. Strict Enforcement: There should be strict penalties for departments and hospital administrators who force resident doctors to work beyond the stipulated hours.
4. Technological Solutions: Hospitals can leverage technology to streamline administrative tasks, which would free up doctors' time and allow them to focus on patient care.
5. Mental Health Support: Resident doctors need access to mental health counseling and support systems to help them cope with the stress and pressures of their profession.

The AIIMS OM is a moment of hope, a signal that the authorities are finally acknowledging the plight of resident doctors. However, as the RDA president Dr. Sai Kaustubh has rightly pointed out, unless it is backed by a concrete plan to address the manpower shortage, it will remain just another piece of paper. The ball is now in the court of the administration to translate this directive into a tangible reality. The welfare of the doctors and the safety of the patients depend on it