One in two hospital doctors are working dangerously long hours, but mandating maximum work times is not the answer, according to the AMA.

The national doctors’ association’s latest survey of salaried doctors and doctors-in-training found 53% are working hours that put them at risk of fatigue, with those working in intensive care, surgery, obstetrics and gynaecology at most risk.

This figure remains identical to when the survey was last performed in 2011.

The survey of 716 doctors (including 675 who are hospital-based) who kept diaries of their work and non-work hours over one week, revealed the average work shift was 18 hours, almost one in two doctors did not take a meal break on three separate work days and the longest work shift was 76 hours.

These results are red flags that public hospitals need to urgently address in their rostering arrangements, said the AMA, which noted 80% of participants were junior doctors also dealing with study and exams.

AMA Council of Doctors in Training chair Dr John Zorbas said fatigue was a major concern, considering the impact it can have on doctors’ wellbeing and mental health.

“What this shows is a system understaffed and underfunded,” he said.

In many cases, he believes unrostered hours are going unpaid, because the hospital culture discourages doctors from claiming overtime, he said.

“If you look at industrial agreements and the rostered hours they should be reaching, you would have to draw the conclusion they are not being paid,” he said.

Aside from contributing to fatigue, working well beyond rostered structured hours had other negative consequences.

“When you enter after-hours structures there are fewer senior doctors around to give supervision.”

But the answer isn’t as simple as mandating maximum working hours and meal breaks in industry agreements, he said.

“Medicine is too complicated for that. What we do know is there are ways to roster people safely, like appropriate rolling rosters, and providing an appropriate number of days off after night shifts.

“Locking (these changes) into contracts won’t work, we need to change the culture,” he said.

“If I had to change one thing to make system better it would be greater engagement between doctors and employers in rostering.”

“I don’t think the voices of doctors in dangerous or stressful situations are being listened to properly.”