Resident doctors’ workload ‘alarming’; enforce mandatory rest, monitored rosters like for pilots: Panel

The parliamentary health committee has taken a grim view of the substantial vacancies among faculty members, residents and tutors at the central government medical colleges, including the All India Institutes of Medical Sciences (AIIMS), leading to an excessive workload and fatigue in existing staff.

The panel, in a recent report submitted to the parliament, is also alarmed by non-joining and frequent resignations of newly-selected residents at one of the central institutes – the Vardhman Mahavir Medical College (VMMC), New Delhi – and has sought a plan to retain the medical staff. It has also asked for the rationalisation of resident doctors’ duty hours and a fatigue management protocol, similar to the one in place for commercial pilots, to minimise clinical errors and prevent burnout.

Samajwadi Party leader and Rajya Sabha member Ram Gopal Yadav heads the parliamentary standing committee on health and family welfare.

AIIMS, LHMC vacancies; residents dodge VMMC

The committee has expressed concerns over the persistent staff shortage, especially among teaching cadres, at AIIMS Delhi and other campuses, VMMC, Lady Hardinge Medical College (LHMC) New Delhi and Atal Bihari Vajpayee Institute of Medical Sciences (ABVIMS) New Delhi.

The report records that as many as 37.75% faculty positions across the new and established AIIMS are currently lying vacant. At LHMC, 652 out of 2,225 posts (almost 29%) are unfilled, with the institute’s College of Nursing working with a mere 9% of its sanctioned strength of tutors. The vacancy proportion among teaching doctors is 21%.

While ABVIMS reported a critically high vacancy rate of 47.4% among senior residents, VMMC informed the committee members that a significant number of selected senior residents – 41 out of 305 in 2023 and 52 out of 376 in 2025 – didn’t join the institute in the last three years.

Measures to retain doctors

The panel stressed that the high proportion of vacancies adversely affects everything from the quality of clinical services to research productivity to faculty workload. It suggested several measures to improve working conditions and retain the teaching staff, including adequate accommodation, transport facilities, career progression avenues, and structured leadership opportunities for doctors with managerial qualifications.

“The committee further observes that faculty members are currently burdened with excessive academic, clinical, examination, and research responsibilities due to vacant teaching posts, even though the student-teacher ratio may formally meet regulatory norms. Given the substantial clinical workload and implementation of multiple national health programmes, the department should ensure expeditious filling of teaching cadre posts and strengthen supportive administrative structures to enable faculty to focus on academic excellence and patient care,” reads the report.

Resident doctors’ burnout risk

Expressing concern over the high rates of non-joining and frequent resignations at VMMC, the committee asked the college to undertake an "Exit and Non-Joiner Survey" to examine why candidates prefer other institutions or opportunities abroad. Besides providing better amenities, emoluments and promotion avenues to the recruited doctors, the panel also suggested a ‘targeted lateral entry’ mechanism for the departments facing 100% vacancies.

The panel reiterated its stance against excessive reliance on contractual staff at medical colleges. “While contractual engagement may be used as a short-term stop-gap arrangement, it should not substitute regular appointments, as excessive reliance on contractual staff may dilute institutional accountability and continuity,” says the report.

The committee also highlighted the need to rationalise and strictly regulate to prevent fatigue-induced clinical errors. The “unregulated” and “alarmingly prolonged” working hours of junior and senior residents – sometimes stretching up to 24-36 hours – pose serious risks to both healthcare providers and patients, asserts the report.

“The committee is concerned about excessive continuous duty hours for Junior and Senior Residents and the risk of clinical errors and burnout, thereby compromising patient safety. The committee, therefore, recommends that the department formulate and strictly enforce a "Clinical Duty Hours Regulation" policy with mandatory rest periods, and monitored rosters, drawing a direct analogy from other safety-critical professions like civil aviation to prevent fatigue-induced accidents,” reads the report.

Additionally, the panel sought better supervision of residents by faculty members, structured training for staff and adoption of Artificial Intelligence (AI) and Information and Communication Technology (ICT)-based hospital management systems to mitigate the human resource constraints. It also suggests the integration of yoga and the Indian Knowledge System (IKS) to address the rising incidence of depression and psychiatric issues among the medical community.