THERE has always been a lot of criticism about doctors for their alleged negligence and dereliction of duty. But people hardly know how painful and challengingyoungdoctors`career could be, at least in the phase right after their graduation.

The medical clerkship, or house job, is the transition phase from the theoretical tothe practicalaspectofthelearning process. This is surely a milestone in a doctor`s career. Unfortunately, a house job at the Jinnah Postgraduate Medical Centre (JPMC), one of the leading tertiary care facilities in Karachi, is a nightmare owing to the apathy of the hospital administration which complicates a lot of other issues as well.

For starters, despite the fact that house officers are merely fresh graduates with no hands-on experience, they are made the custodians of wards at the JPMC.

They perform all sorts of duties in terms of patient care; duties they are not capable of handling and which involve decisions that they are not even supposed to take in that phase of their professional life. However, unlike residents and consultants, most house officers do not get a penny for their time and services, which is no less than a cruel joke considering the prevailing hyperinflation.

Second, house officers are nothing more than learners with a degree, but they are forced to work for more than 30 hours on a stretch,forthereis`callduty` every three to four days without having supervision of senior doctors.

Owing to this lack of supervision by senior doctors, a house officer does not learn new things during one`s tenure. Whatever they learn, it is out of trial and error.Even when the seniors are around, the house officers do not get to learn a great deal from them. This is so because in the presence ofthe seniors,the house officers are usually assigned the duty of drawing blood samples, going to the laboratory, standing in the same queue as the patients, and waiting for their turn which takes hours. They then come back to the ward, check the file for orders other than blood investigations, and take the patient for relevant tests, such as echocardiogram, ultrasound, etc.

This way they spend less than 25 per cent of their time in learning/training, while the remaining time is spent doing nothingexcepttasksthatshouldbe performed by the paramedical staff.

Across the one-year phase, house officers, if they are lucky enough, spend hardly 1pc of their time interacting with some consultant.

Besides, an eight-hour work shift is the norm globally, and research has proved that an average human cannot perform duties effectively beyond eight hours on a stretch. At the JPMC, however, house officers are subjected to harsh and painfully long hours in the wards and operation theatres without being allowed any rest. Each house officer has tolook after about10-15 patientsfor around 30 hours straight. Forget the house officers, just imagine the plight of the patients receiving such `care`.

To add insult to injury, after all this hard work, the house officers are supposed to put up with and tolerate insults from patients and their attendants as well as from their own seniors.

To addresstheseissues ofyoung healthcare professionals, the JPMC administration must stop hiring unpaid house officers, and provide them stipends so that they may take care of at least the daily expenses, including transportation. Doctors are qualified professionals who acquire their MBBS degree after burning the proverbial midnight oil for five long, hard years.

Under the prevailing laws, even an unskilled labourer is entitled to get Rs25,000 per month as minimum wage.

Is asking a stipendfor doctors like asking for the moon? As house job is basically meant to provide hands-on experience to young medical graduates, there should also be an increase in house officers` interaction with consultants for better learning opportunities, and reduced work hours so that they may perform their duties with due enthusiasm and in the right spirit.

Name withheld on request Karachi