15% of doctors put in over 960 hours of overtime, health ministry survey finds

Fifteen percent of hospital doctors in Japan work over 960 hours of overtime per year, a health ministry survey has shown, despite yearslong efforts to address overwork in the medical industry.

The ministry unveiled the figure, which is down from 39.2% in 2016 and 21.2% in 2022 but still far higher than in most other professions, in a new round of expert panel discussions on work style reform for doctors that began on Monday.

Since April 2024, the amount of overtime doctors can perform has been capped at a maximum of 960 hours per year, or 80 hours per month.

But certain hospitals, such as those designated for high-level emergency and cancer care as well as those that employ doctors in training for highly specialized care, have been exempted from this limit, with up to 1,860 hours of overtime per year allowed at such facilities.

The loose cap — twice the level believed to lead to karōshi, or death from overwork — was introduced to soften the impact on regional healthcare, which relies on the dispatching of doctors from big hospitals.

The survey of 13,205 full-time doctors across hospitals in Japan conducted last October also showed that over 20% of those in surgery, OG-GYN and emergency departments put in overtime exceeding 960 hours.

Doctors undergoing specialized training in high-level care are also allowed to put in up to 1,860 overtime hours under the current system.

University hospitals tend to have doctors working longer. The average number of doctors’ overtime logged at university institutions stood at 52.2 hours per week, as opposed to 44.3 hours at others.

The panel will discuss how to further delegate tasks shouldered by doctors to other professionals such as nurses, midwives and pharmacists.

It will also deliberate on how to nudge more hospitals to introduce artificial intelligence and other new technologies to streamline their operations, as well as keep the rising ranks of female doctors from leaving their jobs after childbirth.

Contentious debate is expected on how to judge what is currently considered “self-study,” which is largely not counted as work time. Such work includes preparing for academic presentations and studying for advanced medical degrees.

Over half of the 1,886 hospitals surveyed replied that they have no clear policies on what kind of self-study is considered work. Many cited the difficulty separating clinical practice, training and research, and the lack of record-keeping protocols in place.