WhatsApp messages all hours of night and day come with the job at medical colleges. In West Bengal, there is a difference. Many such chats across medical colleges in the state involve monetary transactions over hospital shifts and emergency room duties, which are bought and sold for fixed rates per hour.Officials said that what started as informal peer adjustments among medical interns has turned into a cash-for-duty network that operates across medical colleges in Kolkata and other parts of the state, allowing interns to trade mandatory rotatory shifts for amounts ranging between Rs 200 and Rs 600 per hour.One such group, named ‘Internship Replacement’, contains more than 255 members who regularly broadcast shift availability and the money expected in return.Also Read | West Bengal to re-verify 1.1 lakh doctors under ‘Know Your Doctor’ driveThe state Health Department has rolled out a biometric attendance system now to check the practice. Health Minister Sharadwat Mukhopadhyay, who says he came across a dental college intern performing duties on behalf of an MBBS intern during a surprise inspection at Murshidabad Medical College, held a meeting this month with principals and vice-presidents of medical colleges where this issue was discussed.Sources said principals of three medical colleges – one based in Kolkata and two in North Bengal – said they had no idea about this “network” under their roofs.Giving the example of one such WhatsApp transaction, an official said a message could be put up on the group asking if anyone was willing to take up an emergency room (ER) shift, with timings specified, such as an “ER evening from 3 pm today” and a “Night ER from 10 pm to 8 am today”, followed by the money on offer.Also Read | Complaint against ex-TMC MLAs linked to Bengal Medical Council for ‘enabling fake doctor scam’Minister Mukhopadhyay told The Indian Express that the practice has been found to be widespread, across “almost all” government hospitals. “We have identified many interns involved, warned them and now we are making biometric attendance mandatory.”Story continues below this adOfficials said that, on an average, a medical college and hospital in Bengal has around 250 interns, who must put in minimum hours for an MBBS degree, performing duties such as taking down case histories of patients for a monthly stipend of Rs 40,000 to Rs 50,000. Only on health grounds or an emergency is an intern allowed exemption from duty, which can stretch from 6 hours to 24, with the requirement that the missed hours be completed later. “There is no attendance system as such… No one checks, honestly,” a Medical Officer at one of the medical colleges and hospitals in Kolkata said.Informally, interns are known to swap duties or ask someone else to cover for them, but that this was being done for money was something officials say they were not aware of. “It is extremely unethical to see interns bargaining over rates to swap duties as if they are grocery shopping,” a resident doctor at a government hospital said, on the condition of anonymity.On the ethical aspect, Tapas Pramanick, Medical Officer in the Emergency Department at R G Kar Medical College and Hospital, told The Indian Express: “There are 10 Medical Officers at R G Kar, so everyone knows us by face. If someone wants to swap, it is always with one of the other nine Medical Officers. But interns have been known to get Ayurveda students and even non-medical friends to step in for them.”Health Department officials said that in districts, they have found situations where junior doctors who have to put in long hours also roping in interns to perform some of their minor duties.Story continues below this adAlso Read | CAG flags acute staff shortages, drug shortages in Bengal’s public health systemPramanick said: “Rotatory internship is an integral part of the MBBS curriculum… meant to develop clinical skills, professional responsibility and competence for patient care. Duty adjustment may be permitted on humanitarian grounds but as per institutional norms or rules. Exchange of money is absolutely unacceptable and totally illegal and against norms.”Pramanick called for strict action against the people involved in such exchanges. “Patient safety must never be compromised at the cost of money.”Dr Soumyadip Roy, earlier a prominent face of the West Bengal Junior Doctors’ Front, said: “Over the last four to five years, this trend has emerged. The potential impact where clinical doctor shifts are being swapped with dental interns or paramedical staff raises serious concerns.”The principal of a medical college and hospital said: “Interns sometimes ask friends or colleagues doing similar courses to swap duties, usually if they need help. But no money can be involved in this.”Story continues below this adThe Health Department also aims to check the practice of proxy duties to ensure that interns complete their clinical training in person. “Our government intends to eradicate all malpractices from the system that started in the previous government,” Mukhopadhyay said.An intern, 23, at a medical college and hospital in Kolkata said it was unfair to paint all of them with the same brush. “A few people might be doing paid swaps, but most of us are working tirelessly according to standard protocols. Let an impartial probe take place and whoever is at fault be held accountable.”Also Read | Bengal gets Rs 3,000 crore Central aid, Ayushman Bharat card rollout from July: SuvenduThe intern added: “The government’s focus should not end at scrutinising us. They need to address the unbearable work pressure and the appalling basic conditions we face daily, from unsanitary washrooms to lack of proper rest areas.”However, an intern at R G Kar Medical College and Hospital said the swapping of duties is an open secret. “Interns often clock 70 to 90 hours a week. During the three-month Community Medicine posting, this can easily cross 250 hours, while critical ward postings can sometimes mean even higher hours. It is a fact that interns hire proxies for money. If someone isn’t interested in a specialty like gynaecology, they might skip the entire rotation and pay a proxy to fill in, paying them up to Rs 30,000 from their stipend of Rs 45,000 monthly. Most interns, however, do this to carve out time to prepare for MD and MS entrance exams,” she said.