Friday, 19 August 2016

Suicide among Indian doctors – High Incidence

Suicide among Indian doctors – High Incidence One of the major public health problems worldwide today is suicide. Every year, there are about 1million suicides and 10 to 20 million attempted suicides. In the USA, suicide is the third-largest cause of death in the age group of 10 to 24 years. The suicide index in India is the highest in the world, as about 21% of the total suicides committed around the world happen in India! This has only increased in the last two decades. At the rate it is increasing, there will come a day when suicide will become the number one killer in India. It is a well-known fact that doctors often do shifts that sometimes last 24 hours without any break or time to eat in between. Practicing physicians and medical students sometimes have to bear punishing workloads. They may also end up taking the blame if something goes wrong or even become frustrated with the changing work culture. There is another fact that is no longer a secret for many in the medical community - the high suicide rate amongst professionals and medical students. According to evidence, doctors are about 1.87 times as likely to commit suicide than those in other areas of work. There has recently been an increase in the rate of suicides among medical professionals (students and doctors). In India, about 37.8% suicides happen in the age group of 15 to 29 years and 51% of these are committed by students and young professionals, the future of our country. In a study conducted in 1996, and again in 2005, it was found that the rate of committing suicide is more likely in female physicians than the males. Medical professionals are also not very comfortable seeking help for the fear of losing licenses or simply because of the feeling that patients may not trust them with their life. A look at the factors leading to suicide Medical students often suffer from depression. Their training is extremely taxing and can take a toll on their mental and physical health. A student may have been a topper in school but things change when they enter medical college. Not being able to score as well can also lead to depression after a point. It is estimated that about 15% to 30% of the medical students and residents suffer from depression. In a study, it was found that a large number of students either contemplated suicide or actually attempted it! Many students resort to non-prescription drug use such as eating painkillers or antidepressants. This could be another factor. Here is a look at some of the risk factors in various groups. 1) Students: lack of competence, poor performance and failing repeatedly in exams, problems with the medium of instruction, use of drugs and painkillers, inability to cope with the stress of studies or practical work. 2) Residents: stress due to long working hours of residency, ragging and harassment by seniors, not getting their choice of subjects, use of drugs and painkillers 3) Senior Doctors: stress of professional life, reputation at stake, self-medication, and inability to recognize the symptoms of depression or fatigue Some warning signs It is possible to avert many a suicide attempt if the warning signs are recognized at the onset. Here are some signs to watch out for. 1) Extreme anxiety or depression, insomnia, agitation, loss of interest in activities, a feeling of hopelessness, persistent negative thoughts, etc. 2) Isolation, self-criticism, self-hatred, despair, and no desire to live 3) Desire to make a will, sudden purchase of things like a gun, rope, pills, or anything else signifying suicidal tendencies. What can be done? It is important to address the concerns of students and healthcare professionals and identify the signs of depression, etc. in the early stages if suicides are to be prevented. 1) Time for rest and recreation: Stress and long working hours can cause burnout. This is one of the main reasons for physical and mental attrition. There should be adequate manpower for staff to work in shifts and get enough rest and recreation. 2) Medical students and patients should take care to indulge in physical activities in order to keep fit. They should take care to eat healthy and accept support and help from peers and family. They should also not feel hesitant in asking for professional help if they suffer from depression. 3) Small groups can be made in colleges, which can meet regularly to discuss the issues that students or seniors face in their day-to-day life. Picnics can be organized to have some time off from the heavy schedule. 4) Colleges and hospitals can have Suicide Hotline / Counseling Services 5) Doctors are aware of what medications to take and this use of non-prescription drugs should be regulated through appropriate measures. Every medical professional is different. Most doctors usually will have a below-average likelihood of committing suicide. This is because they take good care of their physical and mental health, being in the profession that they are. Having said this, it is still important for the medical students and professionals to feel empowered to voice their doubts and fears. It is good to vent feelings: be it about the sadness that engulfed you while signing a death certificate, or about an incorrect prescription made, or the embarrassment of not knowing an answer in class. Dr K.K Aggarwal and Nilesh Aggarwal


  1. We studied in a sub-standard,unrecognized medical college in kerala which did not have teaching staff,patients,infrastructure,essential library books or hospitals.So the people,the politicians and the student leaders used us as pawns to agitate against every successive government.We had to face the police force and the academic atmosphere was in utter mess.The govt. was paying "GHOOS" to the visiting MCI officials who would come regularly to check the status of the medical college;to allow the medical college to go on
    functioning,which it did because of the "GHOOS" paid to MCI officials.With such substandard atmosphere on the campus and the high expectations of the people outside,its difficult not to fall prey to depressive illness.Further,the social security scheme of the IMA is also very weak,unlike people in other profession who do not have to undergo so much stress and still gets all sorts of relief from their unions.What do we get?The damoceles sword of litigation?Which no other profession has to face.Its only after entering a medical college that many realize that this profession is nothing but a bunch of sour grapes.More depression awaits for them when they see,that their salary is a paltry sum when compared to ordinary people with no great credentials to their name.Our unrecognized medicos managed to fly overseas and practice.Many feel cheated when they come to know this.The immigrant officials,the university,the government,the foreign country embassy are all working hand in gloves to absorb such unrecognized medicos into their soil.All these factors makes many others feel sick.

  2. You have only mentioned about suicide rates amongst doctors,not the family life they lead.Probably the divorce rate is also high,as also the risk for substance abuse,stress related illness.We cannot strike work like other people,nor do we have a trade unions which are the strength of the people and not their skills,most often.And that is how they hold the government and public at ransom and have their demands met.Overwork is another problem,burn out syndrome,all these contribute to the high incidence of suicides amongst doctors.This is not a noble profession,instead you are given the tag of nobility which is nothing more than a lip service in exchange for a death warrant.See what happens when one case goes wrong,and they will ensure that all the nobility is shattered.Agression,oppression,hostility,violence from the side of the patient is also a contributory factor.So it is not just marks.People with 50% aggregate which is all what is required to apply for MBBS become successful in their practice with/without capitation fees,and on the other hand of the spectrum,rank holders commit suicide over a railway track.The medical community ie the IMA also cares very little about the welfare of their fellow members,but in other professions or any job,they will strike work and go to any extent to protect the interests of their members.Trade unionism and the right to strike work is one solution to the increasing suicide rates.Why should we as students boycott our classes for the sake of the patients when these very people's activities and behavior do not help us or help support those who are dependent upon us?We should also have the right to strike work because that is the most powerful tool of the working class people.By conferring us the title of nobility and divinity,they are denying us our power.Those who wish to stay out,like the congenitally rich people can stay out and live with the tag of nobility and the occupational risk associated with it.This problem is global,the severity of it may vary from one country to another.But doctors in some western countries do go on strike if their demands are not met with.Without a powerful union,the doctors are a sitting duck for everybody.

  3. Most of those who become doctors have never seen a world beyond their coaching room classes and their study stable.They spend their entire life shuttling between these two points and that is the reason why campus atmosphere looks so pathetically dull,boring,remorseful and lustreless.These are the selfish medicos who in the future go on to create an IMA which is spineless,toothless and voiceless,just like them and other doctors become a victim of these traits.Then there is the issue of victimization by the teaching staff.They want us to prepare us with a curriculum which seems to be out of scope of the curriculum and even that is not the case,they won't have the adequate staff to do so.And if any one were to harbor an opinion that medical education means self-education,then such teaching staff need not be employed.Students can pay money and get the desired marks in the exams.There is a fixed rate which may change from time to time.Mark specific money.You want more marks,dole out more money.

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