Agreement: I AgreeBody: Dear Editor, The recent commentary from Dr Mafi advises that the exception reporting reforms risks reducing doctors to ‘shift workers paid by the minute’. As a resident doctor, I believe that this interpretation misrepresents both the reforms themselves and the reality of working in the NHS. Over the years, I have seen that professionalism can be often conflated with unpaid labour. Foundation year one doctors are paid as little as £18.62 per hour to take on complex and safety critical work (1). Resident doctors' pay has fallen by a fifth since 2008 in real terms (2). Taking that context into account, asking doctors to work additional hours without any recognition is not a mark of vocation but of a system that is all too quick to exploit them. The exception reporting reforms ensures that time spent delivering care beyond contracted hours is visible and valued. This doesn’t erode professionalism; it strengthens it by ensuring that doctors are fairly compensated for their work and that their wellbeing is consistently taken into account. Dr Mafi’s commentary describes the reforms as a ‘small financial benefit’, but they are in fact a significant contractual reform that was hard won. Under the new reforms, employers must provide resident doctors with access to reporting systems within 7 days of starting a new post, with fines for non compliance. Educational and clinical supervisors have been removed from the process; removing the hierarchical barriers that historically discouraged reporting. Up to 2 hours of overtime will be automatically approved by HR, through payment or time off in lieu, and any shift that exceeds the two additional hours requires a safe staffing investigation rather than challenging a doctor's clinical judgement. Claims via exception reporting now have a clear processing timeline of 10 days (7 days from August 2026), with contractual penalties in the form of fines of £250-£500 for access, completion and data breaches (3). These are not superficial changes; they alter the balance of accountability in a fair and meaningful way. It is misleading to suggest that exception reporting encourages a ‘punching timecards’ mentality. Doctors rarely finish early; we often routinely stay late to care for our patients. One of the main purposes of exception reporting is to ensure that doctors are compensated fairly for their time, and to document persistent breaches that reveal unsafe rotas and chronic staff shortages. If we ignore these regularly occurring breaches and pretend they don’t exist, we are also ignoring the systemic root causes of attrition and burnout; the GMC’s National Training Survey found that 61% of trainees are at moderate or high risk of burning out (4). Exception reporting ensures that NHS employers cannot dismiss these pressures as isolated incidents or simply blame doctors for having ‘bad time management’ when in reality doctors are having to hold up a collapsing system every single day. Concerns that removing a supervisor signing off on the reports could weaken training are also misplaced. I agree that supervisors can be vital mentors, but their supervisory role should not be entangled with decisions about contractual rights. Too often in the past, fear of detriment has deterred reporting altogether. Separating the role of a supervisor from reimbursement protects the integrity of the process and empowers the resident to report their true working hours. Exception reporting is a contractual safeguard; a record of when NHS systems are unsafe and a mechanism to ensure employer accountability. The reforms do not reduce doctors to shift workers. They protect us from being treated as expendable volunteers and ensure that safe working and fair pay are no longer left to chance or goodwill. 1. NHS employers. Pay and conditions circular for medical and dental staff. 2025. Available at; https://www.nhsemployers.org/news/pay-and-conditions-circular-medical-an... 2. BMA. Pay restoration for resident doctors in England. 2025. Available at: https://www.bma.org.uk/our-campaigns/resident-doctor-campaigns/pay-in-en... 3. BMA. Exception reporting reforms – summary and FAQs. 2025. Available at: https://www.bma.org.uk/our-campaigns/resident-doctor-campaigns/pay-in-en... 4. GMC. National training survey 2025 results. 2025. Available at: https://www.gmc-uk.org/-/media/documents/national-training-survey-2025-r... No competing Interests: YesThe following competing Interests: Electronic Publication Date: Thursday, October 2, 2025 - 12:48AI use: No, I have not used AIHighwire Comment Subject: Resident doctors shouldn’t depend on exception reportingWorkflow State: ReleasedFull Title: Re: Resident doctors shouldn’t depend on exception reporting Highwire Comment Response to: Resident doctors shouldn’t depend on exception reportingCheck this box if you would like your letter to appear anonymously:: Last Name: WazirFirst name and middle initial: Haseena REmail: haseena.wazir@hotmail.comAddress: EnglandOccupation: Resident DoctorBMJ: Additional Article Info: Rapid responseTwitter: @DrHWazir