A recent survey by the National Medical Commission (NMC) has uncovered distressing insights into the mental health of medical students in India.
The online survey found that one in four MBBS students in India suffers from a mental disorder, while one in three postgraduate medical students has experienced suicidal thoughts, revealing a worrying picture of future healthcare providers.
The survey also highlighted a significant lack of access to mental health services and a strong reluctance to seek help among these students. Many fear privacy violations while others stigma surrounding mental health issues that further discourages them from seeking the help they need, the survey found.
Conducted by a task force established by the country’s apex medical education regulatory body, the survey gathered responses from 25,590 undergraduate students, 5,337 postgraduate students, and 7,035 faculty members.
The findings were detailed in a report titled ‘National Task Force on Mental Health and Well-being of Medical Students.’ It not only highlighted the gravity of the situation but also proposed several recommendations for corrective action.
Here’s a detailed look at the NMC report
Widespread mental health issues
The committee’s survey reveals a troubling prevalence of mental health issues among students. Among undergraduates (UGs), 27.8 per cent reported being diagnosed with a mental health condition, and 16.2 per cent experienced suicidal ideation.
For postgraduates (PGs), the figures are even more alarming: 31.23 per cent have had suicidal thoughts, 10.5 per cent (564 students) contemplated suicide in the past year, and 4.4 per cent (237 PG students) attempted suicide in the last 12 months.
The survey also found that among PG students, nearly 41 per cent of them feel very uncomfortable seeking help for mental issues, while other 44 per cent of students avoided seeking assistance altogether due to concerns about confidentiality, fearing privacy breaches.
Stigma associated with mental health issues also played a significant role, with 20 per cent of students worrying about societal judgment and misunderstanding. Additionally, 16 per cent of PG students reported unspecified obstacles to seeking help.
Further, 36.4 per cent of medical students (9,319) felt they lacked adequate knowledge and skills to manage stress.
There was also a lack of accessibility and quality of mental health services at medical colleges, the report found. About 19 per cent of UG students rated these services as very or somewhat inaccessible, and 19 per cent described their quality as very poor or poor.
“Faculty or mentors are perceived as extremely unsupportive by 4,664 students (18.2 percent),” the report highlighted.
The report called for immediate action and stated, “This level of mental health disorders and suicidal ideation, combined with students’ risk factors, demands urgent and aggressive implementation of intervention programs.”
Working conditions
Managing stress requires breaks, but for postgraduate medical students, this is difficult to achieve.
Nearly 45 per cent of PG students, or 2,432 individuals, reported working over 60 hours a week, with more than 56 per cent (3,020 students) missing their scheduled days off.
“Excessive duty hours pose risks to physical and mental health of medical students and also compromise patient safety,” the task force headed by Dr Suresh Bada Math, a professor of psychiatry at NIMHANS Bangalore quoted as saying by The Times of India.
A significant 42 per cent of students attributed their stress to college administration issues, including patient and family interactions, while the remaining 50 per cent identified faculty and seniors as their primary sources of stress, equally split between the two.
Living conditions in hostels are also a major concern. About 41.6 per cent of MBBS students (10,645) expressed dissatisfaction with their hostel facilities, citing issues with cleanliness and maintenance. Additionally, 33.7 per cent (8,613 students) reported inadequate privacy in their rooms.
Food quality in hostel messes is another pressing issue, with 55.9 per cent of students (14,294) dissatisfied with the meals provided.
The survey also found that insufficient and non-uniform stipends that don’t match living costs or workload, coupled with delays in payments, create significant financial instability for medical students.
About half of the PG students (2,747 or 51.5 percent) reported stress due to the PG seat leaving bond, where students have to pay the state exchequer if they leave their course midway or do not provide services in rural areas or other specified services. Nearly 37.4 percent (1,998) of PG students reported stress related to the rural service bond, affecting a substantial number.
“If these are the concerns faced by future healthcare professionals themselves, their potential in influencing patients to seek help becomes a question that needs to be thought through,” NMC task force said.
What did the report recommend?
The report offered 44 recommendations to address the mental health and working conditions of medical students.
It proposed measures such as providing 24/7 support through the government’s counselling helpline, tele-MANAS, improving amenities in colleges and hostels, and involving families in induction programmes to better understand the pressures faced by medical students.
The report emphasised that “Given the individualised nature of mental health issues and suicidality, a one-size-fits-all solution for suicide prevention is impractical. Addressing this complex challenge requires a sophisticated, multi-faceted approach tailored to meet the unique needs and circumstances of medical students in India.”
Additionally, it recommended that resident doctors work no more than 74 hours per week, with a maximum of 24 hours at a stretch. The proposed schedule includes one day off per week, one 24-hour duty, and 10-hour shifts for the remaining five days. The report stressed, “Ensuring 7 to 8 hours of daily sleep for medical students is crucial for their mental and physical health.”
The report also suggested adopting the pay scale structure and retirement policies of AIIMS-Delhi across all institutions to address compensation disparities, which range from Rs 15,000 to Rs 1 lakh.
“Standardising pay scales, retirement and rotational headship policies across institutions ensures equity and attracts high-quality faculty. Prohibiting private practice for medical teachers and providing non-practicing allowances can maintain the quality and integrity of education,” it stated.
Furthermore, it advocated for the abolition of the bond policy and the establishment of mentor-mentee programs to offer guidance and professional development. These programs should include regular meetings, mentor training, and support for mentees.
At the national level, a permanent member of the National Medical Commission’s (NMC) Ethics and Medical Registration Board (EMRB) should oversee the implementation of these recommendations, the report advised.
With input from agencies
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