Most resident doctors in the city are familiar with this routine: rush around, go without food, sleep or even a bath. There couldn’t be a grater irony for those in a healing profession.
The suicide of Dr. Payal Tadvi has brought into sharp focus the work pressure on resident doctors working in hospitals attached to medical colleges. Besides the allegation of casteist slurs, Tadvi’s parents have said she was harassed by three senior resident doctors who burdened her with so much work that she went without meals or a bath for days on end.
‘No time to breathe’
While Tadvi (26), was a second-year resident doctor in the gynaecology department at B.Y.L. Nair Hospital, her alleged harassers, Dr. Hema Ahuja, Dr. Bhakti Mehare and Dr. Ankita Khandelwal, were in the third year. Resident doctors are medical students pursuing their postgraduation in specialties like gynaecology, paediatrics, orthopaedics etc.
The Hindu spoke to many resident doctors who said the intense work pressure was now a part of the system. “First-year resident doctors who are referred to as JR1 have practically no time to breathe. In some of the busiest departments like gynaecology and orthopaedics, the work pressure is extreme,” said a third-year resident doctor from G.S. Medical College attached to KEM Hospital. He said that during residency, a doctor is not expected to rest or take leave. “Some medicine residents work 60 hours at a stretch. Skipping meals and not having time to bathe is common,” said the doctor. All this is unfair, but part of the system in medical colleges, he said. “Everyone has a different threshold. But over a period of time, one learns to live with it.”
The city’s four civic-run hospitals: KEM, Sion, BYL Nair, and Cooper, have been faced with a heavy patient footfall over the years. For example, B.Y.L. Nair Hospital has a daily footfall of nearly 7,000 to 8,000 people. The footfall at the KEM and Sion Hospital is the same. The state-run J.J., St. George, Cama and G.T. Hospitals in the city too handle a considerable patient load.
The Maharashtra Association of Resident Doctors (MARD) has made repeated pleas to the Directorate of Medical Education and Research demanding workload relief. However, not much has changed over the years.
One of the demands was to streamline the duties and responsibilities of all residents, professors, lecturers and heads of units and departments. “Duties and responsibilities are randomly assigned by the head of the unit or department or by senior residents. There is no consideration on who has worked how much,” said another resident doctor.
He said residents manage the major workload in hospitals. “Senior residents mostly assign tasks to their juniors and it is a process of learning on the job,” said a third-year resident doctor. It is common to have a senior overburdening the junior due to pressure, he said. “However, targeted harassment like in the case of Tadvi is rare.”
A senior resident from the T.N. Medical College attached to B.Y.L. Nair Hospital said most heads of department (HODs) and senior professors are around for a short while. “Their presence, interaction and constant communication are key for the students to cope with pressure. They are therefore termed guides and guardians of medical students,” he said. Hand-holding and communication between HODs and students is often missing. “When we interact with each other, we realise some HODs are actually making a difference in students’ lives while some don’t make any effort to connect.”