Hospitals and psychiatric institutions 2019 in order to instruct young doctors on the work in a drug out-patient clinic and to create incentives for job applications. In August 2019 the works council of Amstetten Regional Clinic, together with the doctors’ representative body, contacted the NPM in writing regarding stress and overwork. The notice spoke of the massive work overload for the doctors of the regional clinic. From the point of view of the NPM, the lack of qualified medical specialists described in this notice was very worrying. Strain on staff at Amstetten Regional Hospital There had been an insufficient number of permanent positions for years. This deficit and additional absenteeism had been compensated for by the existing permanent staff for years. In spring 2019 the situation had worsened due to sick leaves among the permanent staff, particularly in the (emergency room of the) Department of Internal Medicine. A total of nine fulltime equivalents were missing based on the staffing plan. Despite quickly organised emergency measures, such as the partial closure of departments, the situation was no longer tolerable. The regional government of Lower Austria explained in a statement of opinion that different measures had been taken immediately to meet the strained staff situation. Talks were held with both the medical staff and the management of the Department of Internal Medicine as well as with the doctors’ representative and the works council. The situation had normalised as far as possible by the beginning of June 2019. Long-term sick leaves were ended; absenteeism due to pregnancy could be gradually compensated for by hiring trainee assistants. A pilot project was completed with a positive result in the out-patient casualty department during the summer months. The out-patient casualty department was converted into an emergency room with 15 beds where patients with unclear medical conditions can be monitored for up to 24 hours. This relieved the strain on both the in-patient area and the specialist diagnostic area in daily operations. The transfer of the pilot project to permanent operation was announced for November 2019. It was also agreed that employees from the Department of Anaesthesia and Intensive Care will support when there is a shortage of staff in the Department of Internal Medicine. Measures were also taken to quickly fill medical positions that become vacant in future. During a visit to the University Hospital St. Pölten, in particular the Casualty Department and the Intensive Care Unit of Medical Ward 3, Commission 6 observed that the staff has to work additional hours and overtime on a continuous basis. Some of the employees have a considerable amount of remaining leave that cannot be taken. Overtime and remaining leave at University Hospital St. Pölten An analysis of the work schedules showed that doctors work an average of between 16 and 45 additional hours per month. At times, remaining leave of 250 to 450 hours per employee still had to be taken. 50