PETALING JAYA: Even a 60-hour work week is a heavy burden for healthcare workers in the long term.
Between 45 and 48 hours per week is more reasonable and in line with international standards, says the Malaysian Medical Association (MMA).
Its president Datuk Dr Thirunavukarasu Rajoo, who welcomed a circular by the Health Ministry limiting working hours for housemen (HO) to 62 hours, said Malaysia needs to move towards a reasonable maximum work week.
“To get there, we must address the systemic issues that allow long hours to persist.
“This includes a chronic shortage of doctors, inadequate staffing ratios, and a system that has never been properly resourced to function within humane working hours.
“We need both directives and systemic reform,” he said when contacted.
He also said the directive to reduce working hours is not new, but has not been consistently followed on the ground.
“Reports of HOs working up to 85 hours a week are deeply concerning. This is not just a welfare issue.
“HOs are in hospitals to be trained as safe and competent doctors. When they are exhausted, their ability to learn is compromised and patient safety is also at risk.
“The immediate priority is clear. The 60-62 hour weekly cap must be enforced. Hospital directors must be held accountable,” he said.
Dr Thirunavukarasu also said the circular’s reminder to honour HOs’ leave entitlements, was important.
Annual leave and sick leave are not privileges, but rights under existing regulations, he said. “Denying or substituting them is not acceptable.”
The issue of HOs’ working hours resurfaced recently following reports that some junior doctors were still working up to 85 hours a week despite reforms under the flexi-work system introduced in 2019.
A HO at a university hospital said the recent circular has made little difference at her centre, as a flexible shift system has already been in place for several years.
The doctor, who requested anonymity, said the system already operates on rotating short and long shifts that keep working hours within the 60–65 hour range.
She shared internal schedules showing weekly working hours averaging about 61 hours, with shifts divided between shorter 7am–5pm rotations and longer 7am–9pm shifts, alongside night duties.
Departments at her hospital generally adhere to the official shift system and allow doctors to leave once their duties are completed, she said.
“Under the system, housemen are required to complete three long shifts and two short shifts weekly, with night shifts followed by a full day off,” she said.
The HO said discussions on reduced working hours should also consider workload distribution rather than focusing solely on total hours worked.
Some housemen may technically work the same number of hours but carry heavier responsibilities as senior staff tend to rely more heavily on competent junior doctors.
“My colleague and I may work the same 60 hours, but I may feel more tired than her because she does less work than me,” she said.
She also urged policymakers to examine the workload of medical officers and senior doctors, noting that many continue working beyond official hours without additional pay.
“HOs can go home when their shift is finished, but MOs cannot,” she said.
Another HO based in a hospital in Sarawak said they face heavy workloads despite structured shifts that may not exceed 85 hours per week.
Due to the workload, he said HOs often miss meal breaks and even basic rest time, due to constant clinical demands.
“Some can’t even go to the restroom,” he said, adding that his working hours are a mix of long, short and night shifts spanning between 10 and 13 hours each.
“Even though we start early and are able to leave on time, we spend most of our days finishing up administrative work,” he said.
