Rumbles Journal

Her Open Letters: To the Ghana Medical and Dental Council Re: The Hours You Have Never Regulated Dear Members of the Ghana Medical and Dental Council, I am writing based on your own published guidelines and on public research involving your trainees. Your 2015 Guidelines on Housemanship Training set out the structure of training clearly: two years, six-month rotations, progression from House Officer to Senior House Officer. The guidelines do not set a limit on shift length. They do not set a minimum rest period between shifts and does do not include mental health support as part of the training structure. A document that regulates duration and sequence in detail says nothing about the physical condition of the person carrying out that sequence. The data on what this produces is public. A study of obstetric providers at Komfo Anokye Teaching Hospital found that 62 percent reported burnout (Lawrence et al., 2021). A study of health workers in Accra hospitals found burnout severe enough t...

  The Shift Never Ends. Why Ghana's Junior Doctors Are Running on Empty A doctor who hasn't slept in 30 hours is still expected to read your scan correctly, get your dosage right, and notice the thing that doesn't add up. Ghana's health system asks this of its youngest doctors routinely, and calls it training. The Issue House officers, the doctors in their first two years of practice, are the backbone of Ghana's public hospitals. They are also, by design, among the most overworked people in the building. Shifts stretching past 24 hours with minimal rest are standard, not exceptional, in the Ghanaian and wider West African training pipeline. A study of obstetric providers, including house officers, at Komfo Anokye Teaching Hospital in Kumasi found that 62 percent reported burnout (Lawrence et al., 2021). A separate study of health workers in resource-constrained Accra hospitals documented burnout severe enough to produce measurable physiological strain, what research...