Working conditions & your rights

The HPCSA’s internship guidelines put limits on your hours, overtime, supervision, patient load and accommodation. They’re guidelines rather than an Act, but facilities are still held to them, and accreditation visits give them teeth. Knowing the numbers is what lets you raise a problem with confidence.

Hours and overtime

• 40 hours of ordinary time per week.
• Commuted (fixed) overtime capped at 20 hours a week, and 80 hours per four-week cycle.
• No continuous shift beyond 26 hours, which in practice is 24 hours of duty plus a 2-hour handover.
• You shouldn’t be rostered every second night, or work a full weekend without a 12-hour break during it.

That continuous-shift limit was tightened after a newly qualified doctor died in 2016, having worked far too long a post-call shift. Worth remembering when a roster looks unsafe.

Supervision and patient load

• No more than about 25 inpatient beds per intern.
• An intern-to-supervisor ratio of up to about 4:1, with supervisor access around the clock.
• After hours, an intern on duty, a medical officer on first call, and a consultant or supervisor on second call.
• Logbook sign-off for a domain comes from a registered practitioner with at least three years’ post-internship experience in it.

Some of these ratios come from the guidelines and may be revised, so confirm the figures against the current HPCSA guidelines for internship training before relying on them in a dispute.

Accommodation and transport

Every accredited training complex has to provide safe accommodation meeting HPCSA standards, with workable on-call sleeping and recreational facilities. Where your duties need it, transport is a Department of Health vehicle (with a valid licence) or the department’s transport pool.

If your facility falls short

Guidelines only protect you if you use them. Keep your own record of hours worked, and raise breaches in writing through your escalation path: intern representative and curator first, then a formal grievance. HPCSA accreditation depends on meeting these standards, so a documented pattern of breaches is a serious matter for a training complex. Some provinces issue their own continuous-hours rules that apply only locally, so check whether yours has.