Why we need to think about stress among young doctors

Psychological morbidity – the condition of being diseased – among medical students eventually deteriorates their academic performance, and at the same time, increases the risk of substance abuse

Who will treat those who treat others? Many doctors are depressed, drinking heavily, popping stress-relieving pills casually and are often suicidal. They need medical attention — and, urgently. More so the young among them.

According to a survey published in the Indian Journal of Psychiatry, as many as 30% of doctors in India are suffering from depression, while 17% of them have even thought of committing suicide. (Getty Images/iStockphoto)

In India, we have close to eight lakh allopathic medical practitioners, one of the highest in the world. With an excess of 60,000 students graduating every year, their number is growing steadily. They play an active part in the success or the failure of the health system, but their own mental health condition is alarming — what the Indian Medical Association calls a “public health crisis”.

Reasons for the meltdown among doctors could be many.

Before they graduate to become registered doctors, they undergo an intensive four-and-a-half-year training, followed by an exhausting one-year internship. Thereafter, a select few get an opportunity to reach post-graduate level where they negotiate an equally rigorous process that matches with an unorganised sector blue-collar job in terms of work hours and a call centre’s in its schedule. Add to that the stress of saving lives and seeing trauma from close quarters.

Not everyone can take it. According to a survey published in the Indian Journal of Psychiatry, as many as 30% of doctors in India are suffering from depression, while 17% of them have even thought of committing suicide.

Another study by the Indian Journal of Critical Care Medicine suggests that 21% of doctors consume alcohol in higher volumes, 18% are dependent on antidepressants, 14% are heavy smokers, and doctors as well as nurses who work in the Intensive Care Unit routinely report auditory hallucinations.

Things complicate further when we talk about resident doctors, who are in their phase of the course. Suicide has now become the second leading cause of death in 15 to 29 year olds in India and there is no significant reason the young in the medical profession would find themselves completely unscathed.

Psychological morbidity — the condition of being diseased — among medical students eventually deteriorates their academic performance, and, at the same time, increases the risk of substance abuse. Attrition from the profession, inability to maintain an effective doctor-patient relationship, failure to establish healthy interpersonal relationships, suicidal thoughts, despondency, feeling of worthlessness and guilt are some of the complications that eventually creep in. In the long run, they end up contributing to the failure of the healthcare system in the country.

The neglect of medical students — and a general disregard for — mental ailments by most around us is a sign of a deeper systemic failure. There are few reliable studies conducted among young medicos, making constructive response to the crisis a difficult task.

The solution, however, lies in the basics. If we wish to deliver effective universal health care in the long run, we need to bring in an academic plan that not only trains the medical workforce to deliver better services to patients and communities but which also radically reforms the way we address the factors contributing to mental aliments among young doctors. In short, students’ psychology needs an immediate attention. Our medical institutions must have an accessible counselling service, and, to augment that, a functioning helpline.

In their quest to serve society, doctors invariably suffer, and most of the times, ironically, they have no one to turn to. Mental ailment still remains a social stigma; and as surprising as it may sound, many doctors find it equally hard to defy social norms — including for reasons such as doctors being seen as incapable of treating others as they are suffering from a mental health condition.

We already have a relatively low doctor to patient density — only one allopathic doctor for 1600 patients as compared to the WHO prescription of 1 for 1000. That should be the reason enough to make us think about the issue more than ever.

Sifat Tanveer is a medical student at Jawaharlal Nehru Medical College, Aligarh Muslim University

The views expressed are personal