CHANDIGARH: It is common for NGOs and select government bodies to set up suicide helplines ahead of key exams which are known to create stress. But in a rare move, the Post graduate Institute of Medical Education and Research (PGIMER) Chandigarh started an inhouse 24X7 crisis helpline after two resident doctors killed themselves in 2016.An analysis of the helpline calls reveals something not commonly heard. One of the causes of stress among resident doctors was seeing patients dying or those on the verge of dying. For some, it was their inability to even diagnose an ailment despite having read a lot in medicine.This cause is unexpected for doctors who are trained to be detached. However, recent debates on infusing empathy in medical practice have been central to modern medical practices. “Dealing with people dying or those close to death puts a lot of burden and emotional stress on the doctors and many of them break down. Doctors dealing with such cases more frequently should not be posted in such areas for long. These postings should be short and the resident doctors should be given adequate off from work so that they can overcome or learn to deal with their emotional stress,” says Dr Sandeep Grover, psychiatrist who has been working on the crisis helpline at the PGIMER.“I cannot forget the face of a mother who wanted me to save her child, but I could not. This daily haunted and disturbed me,” said a junior resident doctor at the PGIMER.Also, workload and burnout contribute to mental stress which increases during the examination times and when doctors are continuously posted in the emergency. There have been three suicides in the PGIMER of resident doctors since 2016. “We see various types of cases that includes depression, anxiety and problems in adjustments,” adds Grover.It is hard to imagine specialists in PGIMER feeling low when it comes to seeing a patient die on his/her hands. “This usually happens the world over during initial training and it also depends on someone’s personality,” says Prof Amod Gupta, former sub dean at PGIMER.“We are taught to show no signs of emotion to a patient while dealing with him or her. But things are changing. As patients are being treated like case studies and they are losing faith, we emphasise on empathy. And it would make such doctors feel low after coming across critically ill patients who are beyond treatment.”Stress and suicide rates among physicians worldwide have been one of the highest. Two months ago the Indian Medical Association (IMA) formed a national IMA committee for emotional health and well-being of medical students and doctors — “Doctor Know Thyself”.‘Enhance physical, mental wellbeing among residents’The Post graduate Institute of Medical Education and Research (PGIMER) Chandigarh started an inhouse 24X7 crisis helpline after two resident doctors killed themselves in 2016.The Indian Medical Association issued a statement that students of medical colleges in India experience the highest level of stress than students in any other country.The Lancet in September 2017, mentioned in its editorial that in the UK, physician burnout has reached epidemic proportions.The same journal documented that the suicide rate in the US in 2016 was 400 physicians per year, which was more than double that of the general population.“Keeping in view the high stress and high physical and psychological morbidity among the residents, medical colleges must initiate efforts to enhance physical and mental wellbeing among residents,” said Dr B S Chavan, head of psychiatry department at Government Medical College and Hospital, Chandigarh.

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