State of Doctors: Horror Stories of Overworked Kolkata Docs

In a profession where mistakes can cost lives, there’s almost no attention being paid to this deadly medical crisis.

India’s junior doctors are inhumanly overworked.

(Photo: Altered by The Quint)

A young doctor confesses, “After a 24-hour shift, I had to go to the Operation Theatre for more work. But I was so tired that I went there and asked for permission to sleep. I slept in the OT under the table, and it’s horrible that I had to do that.”

India’s junior doctors are inhumanly overworked. It’s severely harming their own health, and the quality of healthcare provided to their patients. Despite being in a profession where their mistakes can cost lives, there is hardly any attention being paid to this deadly medical crisis.

In a special podcast on The Quint, overworked and sleep-deprived junior doctors speak up on condition of anonymity, against the exploitative conditions in which they work in government hospitals, and how dangerous it is for the patients under their care.

These are voices of young post-graduate doctors from Kolkata’s top medical colleges.

A 27-year-old doctor who recently completed his post-graduate Master of Surgery (MS) course, reveals the toll it takes on the doctors, “There’s an inhuman workload on junior doctors. They are doing continuous shifts of up to 36 hours and 48 hours at one stretch. And this is happening routinely. They are made to do 24 hours of on-call duty, ward work and emergency duty and then right after that (24 hours into their shift), they are made to work in the Operation Theatre. So, they are operating in the Emergency Room and the OT under stress and in a completely sleep-deprived condition. It’s immense pressure. Many friends of mine could not cope up with this and a few of them even tried to commit suicide.”

“Post-graduation should be about learning and not about torturing yourself.”

A doctor currently undergoing his post-graduate traineeship

A 36-Hour Day in the Life of an Overworked Doctor

(Graphic: The Quint)

We asked a junior doctor to take us through what a 36-hour shift in a public hospital is like. Here’s a day in his life, or rather a day and a half. Listen in.

The Impact of Being Overworked

These terrible working conditions have far-reaching adverse effects on the health of doctors and patients.

Dr Sumit Ray, a leading intensive care specialist in Delhi, explains:

“There are studies which have shown that if you have stretches of work beyond 24 hours, your performance surely goes down. After a while, your physical skills decline if you have been working very hard for long hours.”

A resident doctor in Kolkata admits, “It does cloud your concentration. Sometimes, you have to write drug advice for the patient which the nurses will administer. You have to be very accurate but if you’re that overworked, you are likely to make mistakes. It can end up doing serious harm to the patients. It’s a direct consequence of resident doctors being overworked. In case of surgical subjects, being sleep-deprived can affect your handiwork as well.”

And that’s not all. He continues, “We have to go for our evening rounds in a sleep-deprived condition, after having worked for more than 30 hours already. We might end up missing subtle signs about the patient’s health and whether some critical intervention is required. That could even end up being fatal.”

Another doctor adds, “These working hours cause irritability, fatigue, stress, and the doctors are bound to make mistakes, overreact and not behave as well as they would have at the beginning of their shift.”

With the recent violence and assault on doctors at NRS Medical College and Hospital in Kolkata still fresh in the minds of those in the medical community, one of the doctors explains why the behavioural issues arising out of being over-stressed and sleep-deprived is such a big deal.

“The patient-doctor relationship will definitely get hampered by this. This is a major cause for concern because this will lead to more patient-doctor related violence.”

Government Directive Rampantly Flouted

The central government’s directive regarding working hours of junior doctors was issued in 1992 and 27 years later, it’s nowhere close to being followed.

Here’s what the directive says. “Continuous active duty for resident doctors will not normally exceed 12 hours per day. The resident doctors will also require to be on call duty not exceeding 12 hours at a time. The Junior Residents should ordinarily work for 48 hours per week and not more than 12 hours at a stretch.”

The directive also mentions, “Subject to exigencies of work the resident doctors will be allowed one weekly holiday by rotation.”

Unfortunately, the reality is quite different.

The central government’s directive is flouted rampantly, and routinely.(Graphic: Meghnad Bose/The Quint)

Urgent Action Needed

So, what are the steps that can be taken to counter this massive healthcare crisis? Here are some of the suggestions we received from doctors.

• “There should be a forum for post-graduate students to complain if they are being overworked. The complaint should be anonymous, and actions should be taken.”
• “No one should be kept on OT duty right after being on-call for 24 hours. They should be given a break for at least 12 hours.”
• “You have to give proper rest and adequate offs to the doctors after their long working hours, which is not given currently. That is important.”

Veteran intensive care specialist Dr Sumit Ray ends by saying, “If you do not invest more on people and infrastructure in the public health system, then these problems will not go away. You will need more people, because the hospital has to run 24x7, so the only way to do it is by employing more people.”

Dr Ray adds, “Also, probably share a bigger burden of work on the senior doctors than is currently done. They could be asked to do night shifts. Though their night shifts could be fewer in frequency than the juniors, they should also have to cover the night as part of their scheduled work, especially those in departments that are critical to the hospital. Night shifts should not be left solely to the junior doctors, that way the patient care is also better.”

For any of these suggestions to be implemented or even deliberated though, what we first need is that our politicians, policymakers and hospital administrators understand the urgency of the crisis posed by inhumanly overworked doctors.

What’s the state of doctors in other parts of the country? Find out in our series:

Delhi
Mumbai
Bengaluru
Tamil Nadu
Gorakhpur
Bihar