🇩🇪 24/7 Guardians: Unveiling the working times of doctors in German hospitals

• Introduction

In this article, we are going to explain the working times of doctors in German hospitals.

• Working times of doctors in German hospitals

The working times vary a little from one specialty to another and from one hospital to another. But the differences are easy to explain.

• Regular working hours

They are 40 hours per week in the more than 1900 hospitals in Germany. These 40 hours are divided into 8 hours per day from Monday to Friday. On Saturdays and Sundays, there are only one or two doctors each day doing the shifts.

In University hospitals the regular working hours are “officially” 42 hours per week, but unofficially, they could reach 80 hours (including the night shifts). Most of these extra hours are usually not paid or taken as free time.

• Starting and ending times of the regular working hours

Generally, surgical specialties start to work early. We can say around 06:30 to 07:30 AM. Most other specialties would start working between 07:30 and 08:00 AM. By law, there should be a 30- to 45-minute unpaid rest time (🇩🇪 die Pause) in the middle. The regular working hours are 8 hours, so, surgical specialties would be able to go home around 03:00 to 04:00 PM. Most other specialties around 04:30 PM.

💡 It is common that residents in surgical specialties stay working for longer hours. Around 1 to 3 hours extra per day. In University hospitals, some stay until 8 or 9 PM. So, do not be so sad if you did not get a residency position in the University Hospital of Heidelberg!!!

• Night shifts

Small- and medium-sized hospitals have a system in which each resident needs to do around 3–4 times per month night shift during the week. Many start working regularly on that day (in some hospitals, you start working around 1–3 hours later). You do your normal ward work and then after about 4 PM, you start your night shift, until the next day.

In large hospitals, they have night shift systems. So, you might work for 4 or 5 nights in a row, starting from 8 pm and ending at 8 am the next day. Then you will have 3 to 4 days without work. This working system generates less money than the above system because residents end up working around 160 hours a month. Doing extra night shifts generates more money. We explained how the paying is in this article:

• Shifts on the weekend

Working laws allow doctors now to maximally work two weekends per month. In small- and medium-sized hospitals, many work 24 hours. This is a very well-paid shift, and you are then often required only to do one such shift per month. Other doctors say that they cannot work 24 hours and prefer to do two times 12 hours at two weekends. Others did 2 or 3 shifts for 24 hours per month on the weekend (like me!)

• Three shifts model

In large hospitals and large departments, there are sometimes three shifts in the intensive care unit, Stroke Unit or Emergency department. This means that some doctors might start working at 8 AM, others 8 hours later at 4 PM and others around 10 PM.

Sometimes, there is a “middle shift”, like in the Stroke Units. One doctor starts at 8 AM, another around 12 AM, and the last one at 4 PM. The doctors who started at 8 AM goes home at 04:30 PM and the one who started at 12 AM goes home at 08:30 PM. The one who started at 4 PM remains until the next day (his shift is then around 16 hours).

• On-call duty (🇩🇪 die Rufbereitschaft)

This is usually for specialties like Urology, ENT, Ophthalmology, and Dermatology in small- and medium-sized hospitals. The doctor who has the shift does not remain in the hospital and can go to his home, but he is expected in emergency cases to come back to the hospital.

• Which working models are the best?

It depends on your goal:

Earn a lot of money extra to your monthly salary
have less free time
Earn little extra money
Have more free time for your hobbies, family, research, etc
Then the normal system with 24-hour shifts and shifts on the weekends. In this system, many residents work on average around 40 hours extra. This generates a net extra income of around 100–1400 euros per month.Then the three-shift system and the night-shift system cause you to work around 160 hours per month (equal to the regular working hours). So, you have more free time BUT less extra money to your salary. The extra pay is for the night shifts (around 200 to 300 euros per month as net salary)

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