“At one point, I wanted to send everything out for a walk.
Medicine… Life too, I thought about it, ”says Xavier *, 31 years old.
During his years of internship in the hospitals of Ile-de-France, dark thoughts came to torment him.
He was able to find an attentive ear with his head of department.
“I was lucky,” he said almost four years later.
“But I was far from being an isolated case.
"
Since the beginning of the year, already four interns have ended their days. The cause of the discomfort is however well known: the infernal pace and the daily pressures. "Working time is what endangers both students and patients," protested Gaëtan Casanova, president of the National Intersyndicale des Interns en Medecine (ISNI), who called on Friday for a strike of 48 hours, and demonstrated this Saturday in Paris with, as a watchword, "protect your internal".
Their demand "is simple": "that the law be respected".
Despite a 2015 decree which sets the work limit for interns at 48 hours per week - the legal maximum authorized by the European Union - these some 30,000 student-doctors work an average of 58.4 hours, according to a report by the European Union. 'ISNI published in May 2020. In seven surgical specialties, working hours even exceed 70 hours.
"This figure does not include, moreover, the hours that the interns spend at their home or at the faculty to work on their research projects or on the presentations that they and they make very regularly in their service", recalls the union. .
Fear of medical errors
During his internships at the hospital, Xavier had around 70 hours of work per week, "with peaks at 94 hours". “And when I was doing 60 hours in seven days, it was quite a good week! »Quips the young man, who has become a general practitioner in rural areas. But "to work so much, you end up doing bullshit and having to live with it". Gaëtan Casanova remembers the time he had to give an epidural to a patient after "having worked 22 consecutive hours with a heavy workload". "I missed it, the consequences could have been very serious," laments the 32-year-old intern.
Why such an overload of work for these doctors still in training?
“The main problem, of course, is money, Judge Xavier.
The hospital lacks funds.
Just look at the condition of the buildings, it looks like they are going to collapse!
And the doctors are always just in time ”.
While he still has postgraduate student status, the intern is "a pillar" in the department in which he works, according to Xavier.
“We can't do without him, he's cheap labor.
"
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"Too many administrative tasks are on us," adds Morgan Caillault, 28, president of the Autonomous National Intersyndicale and representative of general medicine interns (ISNAR-IMG). For Gaëtan Casanova (ISNI) this overload weighs for a third of the working time. “Why hire a secretary when you can use the intern who is paid at a fixed rate? "The government has revalued their salary at the end of 2020, but" not everything can be bought ", asserts the intern. “That won't stop them from being exhausted and making medical errors. "
Already in 2017, the unions warned against the psychosocial risks of overworking medical students and young doctors.
According to their survey, 23.7% of them had had suicidal thoughts, 27.7% suffered from depressive disorders and 66.2% from anxiety.
The problem has long remained trivialized by a culture of "we suffer in silence", notes Xavier.
“Notably because previous generations have also suffered without saying anything.
The environment is not really benevolent, cracking can be taken for weakness and we do not have the right to be weak, ”summarizes the doctor.
Count the working hours
In order to protect the health of interns, ISNI requires a count of working hours. “Today, we are counted in half-days. However, the half-days have no time limit, we are on the pifometer according to the chefs (
Editor's note: who fill the duty rosters
) ”, explains Gaëtan Casanova.
The ISNAR-IMG union wants to go further. "We fear that an hourly count is not enough as long as there are no sanctions," said the intern in Center-Val de Loire, Morgan Caillault. He asks for "an hourly demarcation of half-days defined at 5.20 am maximum and that the interns keep their own roster in addition to that of their boss". The idea, he explains, would be that an "independent structure, composed in particular of a lawyer, can compare these two tables and impose sanctions if it finds a drift".
“I know what our healthcare system owes to interns.
Together, we are committed to improving their working conditions, starting with the duration of their work, ”Olivier Véran tweeted in April.
An investigation into respect for working time in hospitals is to be launched soon by the ministry.
"We will check how many half-days the interns do, except that as long as these are not limited, we will not obtain improvements", regrets Gaëtan Casanova.
I know what our health care system owes to the Interns.
I have heard from their representatives today.
Together, we are committed to improving their working conditions, starting with their working hours.
pic.twitter.com/SiKjzDC7o9
- Olivier Véran (@olivierveran) April 15, 2021
The young man was received this Saturday afternoon at the Ministry of Health: "They do not change position," he annoys.
Contacted, the ministry had not responded to our requests at the end of the day.
ISNI also lodged an appeal with the Council of State in November 2020. "The investigation of the case will be closed in the coming days", specifies Gaëtan Casanova, who is also awaiting the conclusions of a new investigation into the state. health care providers next month.
“The results will likely be even more alarming.
The causes of the discomfort pre-existed the health crisis and the Covid certainly did not fix them, ”he underlines.
* The first name has been changed