• Kyodo

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More than 2,000 doctors at 50 university hospitals in Japan have been working without pay, and many lack employment contracts or compensation insurance, the education ministry said Friday, based on a recent survey.

“The findings are very regrettable, and it is only natural to correct the practice of not rewarding doctors who should be paid,” education minister Masahiko Shibayama said.

Japanese university hospitals have a practice of not paying wages to doctors who treat patients as part of research or training, as many of them are graduate students.

But the widespread practice has forced such doctors to work part-time jobs at other institutions to make a living, often exhausting them to the point that they fall asleep while treating patients.

More reports of unpaid doctors are expected to surface as reviews on the status of more than 1,300 doctors are still pending. Experts say the latest findings are only the tip of the iceberg, as surveying methods vary at each hospital.

The universities are eventually expected to pay the uncompensated doctors and sign employment contracts with them once they are instructed to do so by the ministry.

The ministry had previously surveyed graduate students on whether they had signed contracts with their university hospitals, but the survey did not focus on unpaid doctors.

The survey, conducted between January and May and targeting 31,801 doctors and dentists who worked at 108 university hospitals in September last year, found that 2,191 doctors, or 7 percent, went unpaid.

Of them, 751 doctors at 27 hospitals were found to have been denied pay without a rational reason, including some who worked four days a week despite contracts stating they should only work twice a week. The hospitals will make retroactive payments for their services dating back two years.

The remaining 1,440 doctors at 35 hospitals were unpaid for a reason, but the hospitals have decided to pay their wages from now on, given the frequency and the extent of services they are providing.

Among the surveyed doctors, 1,630 had not signed employment contracts without a rational reason and 1,705 were without industrial accident compensation insurance.

“University hospitals have taken advantage of our conscience and exploited us,” said a doctor in his 30s in Tokyo who was forced to work full time six days a week as a graduate student even though his contract said he could only work slightly over 10 hours a month.

To pay his tuition and make a living, he had to take up a part-time job that put him on night shifts for up to 15 days a month.

Looking back, he said, “I was constantly sleepy and exhausted.” The doctor said he nearly fell asleep during an operation and while he was listening to a patient’s heart.

“This is not us asking ‘help us poor unpaid doctors.’ The lives of patients are at a risk if our lack of sleep interferes with our work and if we collapse while conducting an operation,” the doctor said.

Naoto Ueyama, who heads a labor union of doctors in Japan, said the latest figures do not reflect the actual number of unpaid doctors. He called for them to be paid in addition to being given contracts.

“Even if the doctors are at hospitals for training or research, they obviously need to be paid as the doctors are treating patients as licensed medical practitioners and hospitals are gaining rewards through their services,” Ueyama said.

“Unless there is an employment contract, their working hours are not controlled. Patients could also suffer the disadvantage of not knowing who will take responsibility in case of a medical accident,” he added.

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