NARD Caps Doctors’ Work Week at 48 Hours
The Nigerian Association of Resident Doctors (NARD) has announced new recommended work-hour guidelines for healthcare personnel across the country, capping the working week at 48 hours and limiting continuous duty to a maximum of 24 hours, a move the association says is aimed at curbing burnout and protecting patient safety.
The guidelines, contained in a statement signed by NARD’s Publicity and Social Secretary, Dr Abdulmajid Yahya Ibrahim, emerged from the work of the Federal Ministry of Health and Social Welfare’s Ministerial Committee on Work Hour Regulation and Casualisation of Doctors. The committee had been under pressure to conclude its work after NARD, at its National Executive Council meeting in Gombe in July, threatened a nationwide industrial strike unless outstanding welfare issues, including the panel’s recommendations, were addressed. The association eventually suspended the planned action after the Medical Residency Training Fund was disbursed, though it continued to press for conclusion of the committee’s report.
According to NARD, the recommendations followed a nationwide assessment involving 6,350 healthcare personnel across Nigeria’s six geopolitical zones, which the association said exposed excessive working hours, fatigue and inadequate rest periods among doctors, along with the risks these pose to patients.
Under the framework, healthcare personnel are to work a maximum of 48 hours weekly, inclusive of weekends, with any authorised hours beyond that limit properly documented and compensated above the normal hourly rate, or offset through structured time off. The guidelines further prescribe a maximum eight-hour day shift and a six-hour afternoon shift, while shifts exceeding 12 hours would only be permitted in genuine emergencies.
Call duty is capped at two sessions a week, including weekend calls, with no more than one weekend call permitted in a month. The absolute ceiling for continuous duty, inclusive of call duty, is set at 24 hours. To support recovery, the guidelines require at least 12 hours of rest between regular shifts and a mandatory 24-hour rest period after weekday, Saturday, Sunday or public holiday calls. Doctors are also entitled to a minimum one-hour break after every six hours of continuous work, with breaks to be staggered where necessary to avoid disrupting patient care. Separately, the guidelines set aside protected time for research and professional development, subject to approval by relevant ethics committees.
NARD said the recommendations had already been forwarded to medical directors and chief medical directors nationwide for implementation and urged hospital managements to ensure compliance, while asking members to document and report non-compliance through their centre leadership. The association noted that a second document addressing the casualisation of doctors and abusive locum appointments, an issue it had separately flagged in previous communications with government, was expected to follow.
The announcement comes against the backdrop of months of friction between NARD and the federal government over the pace of implementing welfare commitments. NARD had declared an industrial dispute with government in June and, by late July, was threatening a total and comprehensive strike from 10 August over unresolved concerns, including salary arrears, the casualisation of doctors and the very committee whose recommendations have now been released. The association had specifically demanded that the ministry conclude the committee’s work and implement its findings without further delay, making this week’s disclosure a direct response to one of the grievances that nearly triggered a shutdown of health services.
Nigeria has for decades lacked a clearly enforced national limit on doctors’ working hours, unlike jurisdictions such as the European Union, where resident physicians are capped at 48 hours a week, or the United States, where the Accreditation Council for Graduate Medical Education permits up to 80 hours weekly averaged over four weeks. Research cited in international medical literature has linked work weeks beyond 48 hours to a higher risk of medical errors, near miss incidents and adverse events, a concern NARD has echoed in justifying the new Nigerian framework.
Whether the guidelines take firm hold now depends on compliance at the more than 50 federal, state and private tertiary hospitals where resident doctors work, several of which NARD had earlier accused of ignoring existing welfare agreements. The association said it hoped the National Council on Health would formally approve the recommendations, a step that would give the framework broader policy backing beyond the ministerial committee that produced it.
The association commended the Minister of Health and Social Welfare, Professor Muhammad Ali Pate, and the Minister of State for Health and Social Welfare, Dr Iziaq Adekunle Salako, for supporting the process, alongside NARD representatives on the committee, including Vice President II, Dr Kwarshak Kevin Yakubu, and Secretary-General, Dr Shuaibu Ibrahim.