What we ask

We ask for measurement, protection and a verifiable public response.

The solutions must be simple enough that any hospital, UMF or ministry can answer: whether mechanisms exist, whether they are measured, and whether results are published. If a system requires residents to cover operational gaps, that same system must publicly demonstrate that it protects their training, rest, and ability to report without risk of retaliation.

In short: The demands are simple: measurement, protection, auditing and public response. Each institution must be able to say what exists, what is measured and who is accountable.

  1. Transparent working-time recording: actual hours, shifts, post-call rest and overload episodes reported in aggregate.
  2. Verifiable post-call rule: after an on-call shift, the resident does not stay informally beyond the contractual day schedule; any exception is rare, justified, recorded and audited.
  3. Separation of training from operational work: clear indicators for supervision, procedures, feedback and educational time.
  4. Independent anti-retaliation channel: protected reporting for abuse of power, bullying, harassment and failure to respect rest time.
  5. Public audit of training centers: periodic evaluation of the quality of residency, not just the number of places.
  6. Burnout and migration monitoring: aggregated data by specialties/centers, with intervention plans.
  7. Public salary transparency: the clear, timely and comparable publication of income by function, increments, on-call shifts and legal bases, according to Law 153/2017.
  8. Transparency in hiring and management: tenders, appointments and purchases tracked with public indicators and audit monitoring.
  9. Corrections and documented response: concerned institutions or persons can point to relevant public documents and verifiable measures, not just general positions.
The key question: if a resident says "I can't take it anymore" or "something wrong is happening here", is there a real mechanism to protect them before the risks get worse?

Ward self-sufficiency test

Question

How would the ward function through incumbents, staff employed and clear processes if residents were on leave, externship, course or training period? What deficits become visible when they are no longer covered informally by residents?

Indicator

Non-curriculum hours and tasks should be measured separately: sheets, phones, transportation, follow-up investigations, staffing and post-on-call work.

Standard

Residents can add capacity and continuity, but it should not be the hidden condition for normal service operation.

Anti-substitution standard

Rule

No department should treat residents as permanent substitutes for understaffing, bureaucracy, poor organization, or unequal distribution of work.

Training

Each resident's recurring task must be linkable to curriculum, competency, feedback, or progressive responsibility. If not, it should be moved to the appropriate role.

Limit

The residency must train, not exploit, the career dependence of the young physician as a flexible operational resource.

Transparency about who is producing the activity

Question

Of the department's reported volume, how much is achieved through work by incumbents, how much by residents, and how much by administrative or operational tasks pushed to residents?

indicator

Guards, consultations, sheets, discharges, procedures, interventions, documentation and post-on-call shift time should be analyzed by roles, not hidden in a ward average.

Scope

Not exposing individual doctors, but getting incentives right: real performance, real training, retention and fairly distributed responsibility.

National training capacity map

Seats vs Actual Capacity

Residency positions must be matched with cases, procedures, coordinators, on-call shifts, educational time and anonymous feedback, not just administrative availability.

Overload and underexposure

Centers where residents are used as labor and centers where exposure is insufficient for real competence should be identified.

Annual correction

The distribution of places must be adjusted periodically on dates, with associated rotations where a center cannot provide the full spectrum.

Verifiable digital attendance

What we ask

Card/badge or digital mechanism for entry, exit, on-call shifts, post-on-call shift and overtime for all relevant categories of medical personnel.

After an on-call shift

Post-on-call attendance beyond the contractual day schedule should be treated as a risk, not as normality. Minimum standard: departure home at the latest at the end of the applicable contract program.

What does it protect?

The overworked residents, the incumbents who work and train real, the assistants and the teams that carry the invisible volume of the hospital.

What do we avoid?

Individual data publicly exposed. Aggregates must be public: hours, on-call shifts, imbalances, deficit and corrective measures.