[The de jure and de facto working time situation of assistant and senior physicians in Switzerland]

The legal stipulation of maximum working hours for assistant doctors of 50 hours per week [1, 2] has raised the question of whether the legal requirements are implemented in reality. This question has been looked at for the overall group of doctors [5], but not for the specific medical specialties. The aim of this study was to analyze the de jure and de facto working time situation and its conformity with regard to the specialties of psychiatry, internal medicine and surgery.A representative online survey of around 3,240 assistant and senior physicians in Switzerland was conducted.The analysis of working hours in medicine showed significant differences within the specialist disciplines and in relation to the de jure and de facto working situation. The implementation of the de jure working hours was largely in accordance with the law. Overall, psychiatry had greater flexibility with regard to employment contracts and a lower actual workload compared to the other specialist areas. Nevertheless, the actual de facto working hours deviatefd considerably from those contractually agreed. In addition, there was a discrepancy between the reported and actual hours worked in all departments. The highest additional workload occurred in surgery, followed by internal medicine and then by psychiatry.There is a general non-compliance with the statutory working time regulations in all specialist areas, which points to a systematic problem in the medical sector. The discrepancy between the hours actually worked and the hours reported or contractually agreed, could indicate structural weaknesses and a possible failure in the system. It is important to improve working conditions and to fulfill the legal requirements.