No sleep, no rest, no fair pay: Kerala’s Medical Colleges running on exhausted PG doctors

THIRUVANANTHAPURAM: Post-Graduate (PG) doctors in Kerala’s government medical colleges are pushed to their breaking point. Working without food or sleep, they face a relentless patient load that far outpaces current staffing levels. Without adequate new appointments, these doctors are frequently forced into shifts spanning several days without rest.

Guidelines vs. Reality

The National Medical Commission (NMC) mandates a clear work-life balance for medical professionals:

• NMC Recommendation: 10 hours of duty per day (60 hours/week) with one mandatory day off.
• Kerala Reality: Doctors serve as the sole backbone of emergency departments (casualty) and wards, making these guidelines a distant dream.

During night shifts, PG doctors often manage entire departments alone. Notably, during recent senior doctor strikes, it was the PG doctors who maintained hospital operations and protected the healthcare system from collapse.

Financial burden: High fees, Low pay

Despite their critical role, the government has been slow to provide fair compensation. A promised stipend revision was recently sidelined due to the election cycle.

Stipend History:

• 2019: A 5% increase.
• 2023: A nominal increase of only ₹1,000.
• Current Monthly Stipend (Years 1–3): ₹57,900 | ₹58,900 | ₹60,000.

Interstate Gap: The government justifies these rates by citing lower stipends in neighbouring states, yet the comparison fails to account for educational costs:

• Kerala: Annual fees are approximately ₹80,000.
• Tamil Nadu: While stipends are similar, annual fees are only ₹15,000 (with additional concessions for female students).

House Surgeons: Working Under "Misery"

The one-year mandatory internship (House surgency) for MBBS graduates has become equally gruelling. These interns support PG doctors day and night, often performing tasks outside their clinical scope, such as nursing and attender duties.

• Current Shift Stress: Interns occasionally work four consecutive days without a break.
• Current Stipend: ₹27,350.
• Broken Promises: A 4% annual increase promised in 2022 has yet to be implemented.

Voices from the Frontline

"Most PG doctors are operating on fumes, with no rest in sight. We have formally submitted our application for a stipend increase, and it currently sits with the government awaiting action."

— Dr. Pranav Pramod,

President, Kerala Govt. Medical College PG Doctors Association.

"The pressure would be significantly relieved if the government appointed an adequate number of nurses and nursing assistants. Beyond staffing, a stipend increase is no longer optional—it is a necessity."

— Ananthu,

President, Kerala Govt. Medical College House Surgeons Association.