Survey: 28% of Medical Students Face Mental Health Issues, Urges Work-hour Limits

Nearly 28% of Undergraduate and 15.3% of Postgraduate medical students reported having been diagnosed with mental health conditions, according to an online survey conducted by a National Medical Commission task force.

The survey, which included 25,590 undergraduate students, 5,337 postgraduate students, and 7,035 faculty members recommended that resident doctors work no more than 74 hours per week, get a weekly one-day off and seven-eight hours of daily sleep.

Thoughts of self-harm or suicide in the last 12 months were reported by 16.2% MBBS students while the number was recorded at 31% in Doctor Of Medicine /Master Of Surgert students, according to the report by the National Task Force on Mental Health and Well-being of Medical Students.

According to the task force survey report that was finalised in June this year, feelings of loneliness or social isolation are common, with 8,962 (35%) experiencing them always or often and 9,995 (39.1%) sometimes. Social connectivity is an issue for many, as 8,265 (32.3%) find it difficult to make or maintain social connections and 6,089 (23.8%) find it "somewhat difficult".

Regarding adequate knowledge and skills for managing stress, 36.4% reported that they feel lack of knowledge and skills to manage stress. Faculty or mentors are seen as extremely unsupportive by 18.2%.

According to the survey, the majority of students (56.6%), find their academic workload manageable but heavy, while 20.7% consider it too heavy, and only 1.5% find it light or too light, the survey showed.

"The fear of failure is a significant issue in UG students with 51.6% agreeing or strongly agreeing that it negatively impacts their performance. Furthermore, 10,383 (40.6%) students feel constant pressure to achieve top grades," it showed.

Balancing academic work with personal life is a struggle for 56.3% of UG students.

Medical curriculum-induced stress is a significant factor, with 11,186 (43.7%) finding it extremely or significantly stressful and 9,664 (37.8%) moderately stressful. The frequency of exams is extremely or significantly stressful for 35.9% and moderately stressful for 37.6 per cent, the survey found.

Accessibility to mental health services is rated as very or somewhat inaccessible by 18.6% students and the quality of these services is perceived as very poor or poor by 18.8%.

The analysis of ragging and stress-related parameters for 25,590 undergraduate medical students provides significant insights into their experiences and stress levels.

A majority (76.8%), reported not experiencing or witnessing any form of ragging or harassment, while 9.7% reported such experiences.

Regarding institutional measures, 17,932 (70.1%) students believe their college has adequate measures to prevent and address ragging, while 3,618 (14.1%) disagree, and 4,040 (15.8%) are unsure, the survey showed.

As for PG students, regarding academic stress, 20% students admitted that they find the current academic workload frequently challenging, 9.5% too intense, while 32% reported manageable academic stress levels.

Close to half the PG students (45%) revealed working for more than 60 hours a week with more than 56% not getting their weekly offs.

A significant number of PG students -- 18% -- reported that ragging was still there and hurt them, the task force said underlining "this underscores the ongoing issue of ragging within some academic environments".

It said 1425 (27%) reported experiencing harassment from senior PG students in clinical settings, while 1669 (31%) reported similar experiences from faculty and senior resident doctors.

Awareness regarding anti-ragging regulations is relatively high (84%), but there is still a significant minority (nearly 20%) unaware of these regulations, which suggests the need for increased education and communication efforts, the task force said.

"However, these measures alone are not enough, as indicated by the (18%) substantial proportion of students affected by ragging. This suggests a potential gap in the enforcement of these measures or in the effectiveness of the response systems. Educational institutions must maintain anti-ragging policies, actively enforce them, and ensure that students are both aware of and comfortable accessing support systems," the report said.

Most PG students admitted having experiencing moderate to very high stress levels (84%). However over 40% of them feel that this high perceived stress levels are a way to have the workload reduced.

This underscores the need for effective stress management and mental health support structures within medical institutions, the task force said.

A significant majority of postgraduates, 3419 (64 %), reported that workload adversely affected their mental health and well-being.

They cited factors such as long daily working hours, continuous duty for two-five days, and inadequate infrastructure and support at their work places as contributing stressors.

Additionally, 1034 (19%) of postgraduates expressed the need to alleviate stress through substance use, including tobacco, alcohol, cannabis, and other drugs. Moreover, 1409 (26%) of PG students recognised a strong association between stress and substance use among postgraduates.

Over 10% of 5,337 such students admitted that they planned suicidal attempts in the past one year while additionally, 237 (4.44%) PG students admitted to attempting suicide in the past year.

A notable proportion (17%) of PG students reported inadequate support by their guide during their thesis, emphasising the importance of addressing this issue to uphold educational standards and support student learning effectively.

The presence of 'ghost faculty' in private medical colleges and instances of faculty engaging in private practice during working hours in government medical colleges are significant issues in the medical education sector, the task force said.

"While implementing biometric attendance systems has significantly improved the situation, stricter action and more rigorous implementation are necessary to address these concerns effectively. These practices not only compromise the quality of education but also undermine the integrity of the medical profession," it underlined.

A significant proportion of the PG students are not satisfied with the hostel facilities, with nearly 50% rating them as poor or extremely poor.