Mumbai: Dr Payal Tadvi’s suicide has turned the spotlight on the work pressure at civic-run hospitals. But despite the workload, medical students who suffer from anxiety and depression, are not inclined to take in-house psychiatric help, citing stigmatisation. These students prefer opting for private psychiatric clinics because they fear ‘identification’ just like Dr Tadvi and acquiring a tag of ‘mental’ in their respective departments.
City-based psychiatrists and health experts said, resident doctors who are working in state or civic-run hospitals have to handle considerable stress, which is induced by the work heaped on them by the seniors. The fight between juniors and seniors is commonplace, but it does not mean they should harass the juniors which leads them to undergo counselling to address their depression and sense of low self-esteem.
“On an average 15-20 resident doctors from state and civic-run hospitals undergo counselling sessions at private clinics or dispensaries. This is because they are afraid that if they take in-house counselling, their superiors would get to know about it and might start harassing them even more,” said Dr Sagar Mundada, a psychiatrist. A study conducted on medical students at Nair Hospital some time back revealed that 51.37 per cent of the surveyed medical students suffered from stress while 66.05 per cent were diagnosed with anxiety and 39.44 per cent had depression. This study was published in The Indian Journal of Occupational Therapy (Vol. XXXIX: No. 1).
Psychiatrists also said that during the first year’s residency, most work 36-hour shifts, go without meals or shower. Many, like Tadvi, don’t even get a bed in the hostel and sleep on the floor. Resident doctors have also said they are under constant pressure from day 1 of joining the hospital. The seniors purposely harass or humiliate them without reason in front of patients due to which even the patients stop respecting them. “We come here to learn and gain experience, but we are forced to work non-stop like donkeys due to which we don’t even get time to eat, affecting our health. We slip into depression and take counselling outside the hospital, keeping our seniors in the dark,” said one of the resident doctors. On the Nair hospital campus, which has been grabbing headlines since last week, the opinions are sharply divided.
“Work-burden is a taboo that nobody wants to talk about. At times, it’s inhuman, but there is a line between work-pressure and harassment and that shouldn’t get blurred,” said a second-year resident doctor. A third-year resident said, “We have all faced harsh behaviour at some point, because the stakes are so high in matters of life and death and there is little room for error. But nothing justifies bullying.” In a study, ‘Stress Among Doctors Doing Residency: A Cross-Sectional Study At A Tertiary Care Hospital In The City Of Mumbai’, which was published in 2015 in National Journal of Community Medicine, suggested that counselling and social support would improve the physical and mental well-being of post-graduation doctors.
The report also stated that the amount of anxiety is highest among PG students in their first year. “Residents in the first year of post-graduation experienced significantly more stress as compared to their counterparts in the second and third year,” reads the report. (The finding is given in box below). More interestingly, Dr S R Suryawanshi, head of the department of the community medicine from TN Medical College (Nair Hospital), was part of the study. Total respondents – 273 171 (62 per cent) participants were male and 102 (37 per cent) were female.
Stress level among participants was 37.3 per cent.