The report of the National Task Force on Mental Health and Well-being of Medical Students-2024 has revealed that 84% of postgraduate (PG) medical students experience moderate to very high-stress levels, while 64% say that workload adversely affects their mental health and well-being.
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The report, based on a nation-wide online survey, also showed that an “alarmingly high” 27.8% of undergraduate (UG) medical students and 15.3% of PG students voluntarily indicated having a diagnosed mental health disorder, and 16.2% UG students and 31.2% PG students reported having had suicidal ideation.
Major stressors
They cited factors such as long working hours daily, continuous duty days, and inadequate infrastructure and support as the contributing stressors. “This underscores the need for effective stress management and mental health support structures within medical institutions,” the report argued, having elicited response from 25,590 UG students, 5,337 PG students, and 7,035 faculty members.
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Around 19% of PG students expressed the need to alleviate stress through substance use, including tobacco, alcohol, cannabis, and other drugs. Hence, there was an urgent need to take measures to educate the students and also implement measures to curtail stress, the report said.
With medical training presenting various challenges, including intense competition, emotional stress, financial burden, interpersonal conflicts, limited personal time, and inadequate support, creating an environment conducive to mental health issues, the National Medical Commission (NMC) had formed task force headed by Suresh Bada Math, Professor of Psychiatry, NIMHANS, Bengaluru. The task force conducted an online survey on the mental health and well-being of medical students across the nation.
Financial concerns
The study also finds a link between the high expense of medical education and its link to stress. Around 60.1% of students who responded to the survey felt that their stress and well-being are impacted by financial concerns. A large majority of 72.2% find their stipend insufficient, “pointing to a critical need for review and adjustment of stipend policies.” While 58.4% said they receive their stipends regularly, 41.6% do not, indicating potential areas for improvement. Nearly 50.7% of the PG students said they have financially dependent families.
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Financial stress is a significant issue of UG students as well, with 33.9% students finding their finances extremely or significantly stressful. Educational loans or debt are held by 27.2%, and among them 32.7% said they feel extreme or significant pressure about repayment.
Close to half the PG students surveyed, at 45%, expressed working for more than 60 hours a week with over 56% not getting their weekly offs. About 38% of the PGs reported not having adequate time to rest, while 57% stated that they were denied their weekly off from duty as per NMC regulatory provisions.
Discrimination, a factor
“Discrimination can profoundly impact students’ mental health, academic performance, and well-being. However, 68.80% of PG students reported not facing discrimination based on gender, ethnicity, religion, caste, geography, language, or other factors in their academic environment. But at the same time, a substantial percentage, 31%, of students reported that they are experiencing discrimination, underscoring the need for institutions to implement more robust policies against discrimination and to foster an inclusive environment,” the survey report said.
A significant number of PG students, at 18%, reported that ragging was still there and hurt them. “This underscores the ongoing issue of ragging within some academic environments. About 27% reported experiencing harassment from senior PG students in clinical settings, while 31% reported similar experiences from faculty and senior residents.”
Fear of failure
The fear of failure was underlined by many as leading to various negative behaviours, including procrastination in 52.5% in UG students, skipping classes or assignments in 7.6%, excessive perfectionism in 6%, considering leaving the course in 2.9%, and thoughts of self-harm in 1.3%. “These findings underscore the significant academic pressures and stresses faced by medical students,” noted the report.