28 percent MBBS, 15 percent PG medical students diagnosed with mental health issues: NMC Survey

New Delhi: According to the online survey conducted by a National Medical Commission (NMC) task force, around 28 per cent of MBBS and 15.3 per cent of PG medical students reported having been diagnosed with mental health conditions.

NMC Anti-Ragging Committee had set up the National Task Force to study existing literature and data on the mental health of medical students and propose evidence-based strategies for improving the same.

This Task Force had initiated an online survey, collecting data from medical students, faculties, and administrators regarding mental health history, workload, overall stress level, etc. More than 37,000 medical students had submitted their responses to the government authorities, indicating that they were suffering from mental stress.

After analyzing the data collected from the in-person visit to the medical colleges, the online survey, and the meeting with stakeholders, the Task Force noted that mental health conditions have been diagnosed in 7,115 (27.7%) students, with 3,780 (14.8%) having one condition, 1,851 (7.2%) having two, and 1,045 (4.1%) having three conditions. To ensure the mental health and well-being of medical students, the NMC Task Force has issued the several recommendations to the medical colleges across the country.

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 per cent MBBS students while the number was recorded at 31 per cent in MD/MS students, according to the report by the National Task Force on Mental Health and Well-being of Medical Students.

Regarding adequate knowledge and skills for managing stress, 36.4 per cent reported that they feel lack of knowledge and skills to manage stress.

Faculty or mentors are seen as extremely unsupportive by 18.2 per cent.

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

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

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

Medical curriculum-induced stress is a significant factor, with 11,186 (43.7 per cent) finding it extremely or significantly stressful and 9,664 (37.8 per cent) moderately stressful. The frequency of exams is extremely or significantly stressful for 35.9 per cent 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 per cent students and the quality of these services is perceived as very poor or poor by 18.8 per cent.

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 per cent), reported not experiencing or witnessing any form of ragging or harassment, while 9.7 per cent reported such experiences.

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

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

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

A significant number of PG students -- 18 per cent -- 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 per cent) reported experiencing harassment from senior PG students in clinical settings, while 1669 (31 per cent) reported similar experiences from faculty and senior resident doctors.

Awareness regarding anti-ragging regulations is relatively high (84 per cent), but there is still a significant minority (nearly 20 per cent) 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 per cent) 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 per cent). However over 40 per cent 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 per cent), 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 per cent) of postgraduates expressed the need to alleviate stress through substance use, including tobacco, alcohol, cannabis, and other drugs. Moreover, 1409 (26 per cent) of PG students recognised a strong association between stress and substance use among postgraduates.

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

A notable proportion (17 per cent) 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 per cent rating them as poor or extremely poor.