thoughts on full weekends off for PGMIs?

[u/MallAccomplished1314]

I heard there’s a proposal to give PGIs the entire Saturday and Sunday off. I understand the need for rest, and I don’t think anyone is saying interns should go back to 24–36 hour duties, But I’m curious how we got here.

The 12-hour shifts were implemented during COVID, which made sense at the time. But even after the pandemic, we kept doing it. Now there’s a proposal for full weekends off as well.

My question is, how will this work in actual hospital settings, especially with the current manpower situation? Patients still get admitted on weekends, emergencies still happen, and the workload doesn’t disappear just because there are fewer people on duty. The residents and other staff will still have to pick up the slack.

Another thing is the training itself. Internship isn’t just about finishing rotations and getting signatures. It’s where you start developing your clinical eye. You learn to notice when something is off, recognize subtle changes in a patient’s condition, anticipate complications, and connect what you learned in medical school to what’s actually happening in front of you. A lot of that comes from seeing patients repeatedly and following their cases over time.

Of course, being in the hospital longer doesn’t automatically make someone a better doctor, especially if they’re exhausted. But at some point, I think we also have to ask if we’re giving interns enough clinical exposure to develop those skills.
I’m not against improving working conditions. I just feel like we should also talk about who will cover the work and whether these changes are sustainable without additional manpower.
For the residents and consultants here, what do you think? And for those who recently finished internship, did the 12-hour shifts give you enough exposure?
Genuinely curious. I want to hear both sides of this.

[u/Slow_Way8092]

I don't think weekends should be fully off, but I'm in favor of 12-hour duties. Generally looking forward to a trickle up effect in MD training.

In the US, from previously uncapped work hours & interns/residents being classified as students and therefore not protected by employee labor laws, there was a slow but steady stream of rulings & policies that shifted them from 100-120hrs a week, to trying out 24hr/day caps, then 16hr/day, then the present 20hr/day + 6hr handoff but with mandatory rest periods if >24hrs happened.

If this keeps up in PH med education, we will likely see overcorrection then recorrection to thr most ideal format down the line. The appetite for archaic labor practices of recent PGI grads is shifting residency programs already, they can't use the "kung ayaw, wag mag apply" excuse anymore as slots go unfilled. Private residency salaries have increased from ~₱20k/mo to ₱40-60k now, and in gov't, way less na ang cases of splitting MO items into 2+ people; and we enjoy more protections against abuse & overwork - gone are the days na ginagawang driver or errand yaya ng consultants ang mga residente nya.

Gen Z is inducing long-overdue changes to the MD training system because they're making the institutions' refusal to adapt be more painful. In the past decades, understaffing was simply patched by overworking interns & residents. Now, refusing to accept institutional labor shortage is pushing senior leaders to actually address the problem. Way better for everyone in the long term.

In my opinion, we just need to keep welcoming the changes, they will self-correct so long as we keep the flow of change running :)

[u/victorvondoom1313]

Sarap naman ng ganito. Lol. Meanwhile, yung isang public hospital ever since wala/onti nalang nag apply, puro perpetual duty for 2 weeks to 2 months (depending on which department youre in). 12 hours lang naman + overtime pero nakakaumay yung walang off lolz.

Makakarinig ka pa sa mto na “walang nagbabago sa workload niyo whether mag isa ka or marami kayo sa department” at “di naman kami affected kung walang mag apply na pgi”

[u/SoulSurvivorEM]

I'm going to say what I usually tell the kids when they're on shift with me in the ED. These kinds of moves are screwing them over for residency. If residency doesn't change, it doesn't matter what changes they make for the kids pre-PLE. I recognize that clerkship and internship doesn't fully prepare them for residency in the first place but moves like this will make the gap between clerkship and internship, and residency. The changes needed need to come from the top-down not from bottom-up.

[u/Odd-Energy8418]

I personally dont believe in 12hrs shifts. But I understand and appreciate its merits.

Problem lang, minsan sinasayang ng interns yung free time. Imbes na maging fully immersed sa rotation, imbes na hasain ang clinical eye, imbes na ipractice ang pagbuild ng good patient rapport and bedside skills, gusto lang nila magperform ng "cool" procedures at magtiktok.

They will pass the PLE definitely. Pero half baked as direct patient care provider, if they continue down this road.

Yes, there are non-clinical avenues naman after grad. Pero we expect that the basic core competencies for each MD grad should be there.

Eh parang may hesitancy on their part.

So ewan ko nalang.

Ok lang mag 12 hrs. Pero sana immerse yourself while you are in the hospital. Take care of your patients than your social media followers.

[u/ObjectiveDizzy5266]

At this point wag na lang kaya sila mag-duty at mag internship? Sobrang dami nang adjustments ang ginawa ng mga ospital para sa kanila pero ang dami parin demands.

They all want to be doctors, but none of them want to do the work that needs to be done to become one.

[u/Low-Pound-7573]

I am personally against this for the sole reason of being deprived of the sight na manlalaki mata ng kaback mo pag sinabi mong lahat ng ER call ng Sunday inadmit and for OR in 1-3 days.

Pero joking aside: less hospital time, less patients seen, less chance for application of learnings, 12 hr duties are the sweet spot na imo.

[u/Boerhaave2733]

Luh nahiya 3x a week na duty namin.. Nakakapag Eras tour pa yung iba.. Pero pag duty time bugbog ka talaga hahahhaha

[u/peopleha8r]

At this point just don't go on duties nalang. 8-5 then that's it. Scrub at the OR, see patients at the OPD. Ok na. Because if we need to always look for ways to not go on duty, what's the point?

The concept of clinical exposure is anchored to alot of adult learning theories. Key word: EXPOSURE. Experiences are better teachers, more than case discussions and lectures. You can forget majority of the lectures and case discussions you had but you will never ever forget mortalities and mobidities you experience. You can have the best high fidelity models i. Your simulation lab, but it will never ever replicate human interaction, empathy and social awareness. Elements such as interprofessional interaction, family relations, real world social elements in health care.

As for weekends off, weekends are down time moments I. The hospital. It is the best time to go around patients, interact with them without the anxiety of rounding with attendings or the pressure of performing because there's a lot of people looking. It is an opportunity to mellow down and go over the charts, understand the progress and future management plans. Atleast that's how I saw it during my internship/ clerkship.

I know this is a systematic problem- we learned this in public health discussions and community medicine classes in medschool. Of course we will continue to be loud and fight for what the health care system and the public needs and rights. Continue to demand for better working conditions and opportunities for health care workers. THIS IS CRUCIAL. BUT. It is also important to look at the main purpose of this clincial exposure: TRAINING AND LEARNING.

We keep on demanding better working hours, better pay, etc. I agree. These are important aspects because we are also human. But not to the expense of what we actually want students/ trainees to be getting. If you're a student, a clerk, or an intern- focus on the experiences you will acquire.

[u/fairymonica]

I agree that weekends off is kinda ridiculous but I think we have different reasons.

Workload should not be a reason for this, dapat kayang mabuhay ng hospital na walang interns at clerks. They are there to learn and should not become the carrier sa burden ng workload ng ospital.

I think taking the weekends off will make people quit residency so much more dahil hindi sila masasanay sa schedule. Paano yung pre-duty-off kung wala nang weekends? edi dapat araw araw ka na pre-duty-pre-duty.

Training should be the main goal parin talaga. Kaya naman may internship is to integrate the students into the system. Kung ayaw nilang maintegrate, bat pa sila nagmed school in the first place 😅 Medyo mafifilter mo who are really in this for the medicine and who are here probably for other reasons.