Resident Doctors to be Incorporated into Labor Standards Act|9/1起住院醫師納勞基法 約4680人適用

Starting Sept. 1, resident doctors will be included in the Labor Standards Act. According to a recent Ministry of Labor announcement, this will apply to around 4,680 resident doctors around Taiwan. However, the medical industry is worried that the workhour restrictions will limit clinical study time and make the inadequate training problem worse.


Taiwan's 4,680 resident doctors will be incorporated into the Labor Standards Act on Sept. 1. However, it remains to be seen if this will actually provide residents with any workhour protection due to how often clinical situations arise.

The definition of (workhour standards) under the Labor Standards Act is whether there is supervision or relevant orders, etc. There are innumerable autonomous learning activities. Actually, these are permissible under Labor Standards Act standards. Locked cards and hospitals forcing you to leave work -- these are not mandatory under the Labor Standards Act. Therefore, our union is calling on hospital management to have flexibility when it comes to workhour logs and resident shift management.

Although the change only applies to residents at private hospitals and contract residents at public hospitals, the workhour guidelines and accountability system under Article 84-1 of the Labor Standards Act apply to all residents in Taiwan. The ministry will lower trainee quotas, cancel the status, or deduct points in the evaluations of teaching hospitals that violate these regulations. The medical industry, meanwhile, is worried about the effect on residents' clinical training and say the first generation of residents the changes apply to could turn into insufficiently trained attendings down the line.

Family doctors, for example, only need three and a half years. Plastic surgeons sometimes need five or six years. When you restrict workhours to this timeframe, in three to five years you will start seeing quality issues with residents who have had inadequate training due to workhour restrictions.

In response, the Ministry of Health and Welfare says everyone wants residents to be included in the Labor Standards Act and it will take everyone's opinions into account as it makes rolling adjustments to guidelines and specifications.



經過時間的爭取，9月1號起，住院醫師將納入勞基法，根據勞動部日前公告，全國適用勞基法的住院醫師約4680人，由於臨床狀況多，住院醫師工時是否能夠受到保障，也引發各界關注。

台北市醫師職業工會秘書長 廖郁雯表示：「（工時規範)在勞基法的定義是，有沒有受到指揮監督，或者是相關的命令等等的，非常多的自主學習的活動，其實在勞基法規範裡面它是允許的，鎖卡跟醫院強制你下班，這些都不是勞基法強制規定的，所以我們這邊也要呼籲醫院的管理方，就是在記錄工時，以及在管理住院醫師的上班情形，它必須是更有彈性化。」

雖然法令規定，只有私立醫療院所住院醫師及公立醫療院所約聘住院醫師納入勞基法，但全國所有住院醫師都適用工時指引，也同步適用勞基法84條之1的議定工時也就是俗稱責任制，若醫院違規，衛福部會在教學醫院評鑑中扣點，甚至核減受訓員額或取消教學醫院資格。醫界也憂心，臨床學習受工時限制後，第一批納勞基法的住院醫師，成為獨當一面主治醫師後，訓練不足問題恐怕會浮現。

新光醫院副院長 洪子仁表示：「像家醫科可能3年半就可以了，你如果要訓練一個整型外科，他們有時候到5年6年，你把他工時，限縮在這個框架內的時候，三、五年過後，我們就會看的到說，會不會因為工時的限縮，而影響到住院醫師的受訓的一些品質，跟狀況。」

面對各界的擔憂，衛福部強調，住院醫師納勞基法一直是各界期盼，新制上路後還是會持續收集醫院勞資雙方意見，滾動式調整指引規範。