87 percent doctors sleep-deprived, 62 percent work over 36 hours at a stretch: FAIMA Survey
Doctor
New Delhi: Due to heavy workload and long duty hours, the resident doctors across the country are sleep-deprived, experiencing burnout, and more than half of them are considering leaving residency due to stress, a recent nationwide survey conducted by a doctors' body has revealed.
Altogether, 1260 resident doctors across 28 states and union territories participated in the anonymous online survey, RMS 2.0, launched by the Federation of All India Medical Association (FAIMA). The findings revealed "alarming levels of excessive working hours, inadequate rest, sleep deprivation, burnout, staffing shortages, and psychological stress among resident doctors."
According to the report, approximately 87.5% of the participants reported experiencing burnout symptoms frequently or sometimes. Nearly 87.8% reported sleep deprivation due to duty hours, while 61.8% had worked continuously for more than 36 hours at a stretch.
The report indicated that 54.4% of the participants considered leaving residency because of the stress and workload, and 16.9% admitted to self-harm thoughts related to work stress.
FAIMA mentioned in the report that "The survey findings strongly indicate the urgent need for national reforms regarding resident duty hours, institutional mental health support, staffing, stipend rationalization, and bond policy reforms."
Speaking to Medical Dialogues regarding the survey findings, the President of FAIMA, Dr. Srinath, said, "FAIMA RMS 2.0 Survey Highlights Urgent Need for Reforms in Resident Doctor Welfare. The FAIMA RMS 2.0 Survey, involving 1,260 resident doctors across India, reveals alarming levels of burnout, sleep deprivation, and excessive working hours among postgraduate medical trainees. FAIMA urges immediate systemic reforms such as regulated duty hours, mandatory rest, mental health support, and improved stipends to ensure resident well-being, patient safety, and the future strength of India’s healthcare system."
Medical Dialogues had earlier reported on the nationwide FAIMA–Review Medical System (FAIMA-RMS) survey, conducted across medical colleges throughout India.
In the FAIMA RMS 1.0 survey, more than 2,000 responses from medical students, teachers, and professors across 28 states and Union Territories were submitted, and the findings highlighted significant shortcomings in infrastructure, faculty availability, and the quality of training in newly established medical institutions.
The findings of RMS 1.0 had highlighted the urgent need for systemic reforms and implementation of the National Task Force (NTF) recommendations regarding mental health and working conditions in medical institutions.
Building upon these observations, FAIMA launched RMS 2.0 as a more focused nationwide survey specifically targeting resident doctors, with emphasis on duty hours, workload, burnout, sleep deprivation, bond-related stress, stipend dissatisfaction, and institutional support mechanisms.
RMS 2.0 survey aimed to generate robust evidence-based data to advocate for humane working conditions, safer residency training environments, and comprehensive policy reforms for resident doctors across India.
The objective of this survey was to assess duty hours and workload among resident doctors in India, to evaluate the prevalence of burnout, sleep deprivation, and psychological stress, to analyze institutional support systems for mental health, to evaluate resident perspectives on bond policies and stipend structures, to identify gaps in staffing and working conditions, and to generate evidence-based recommendations for policy reform.
Anonymous responses were gathered from junior residents, senior residents, non-academic residents, and interns on issues including duty hours and workload, burnout and mental health, sleep deprivation, bond and stipend stress, institutional support systems, and policy reform preferences.
Out of 1260 responses, 1087 were received from residents from government medical colleges, 99 responses were from Central Government Institutes, 56 responses were from private medical colleges, and 18 responses were from Corporate Hospitals.
"The analysis revealed widespread excessive duty hours among resident doctors. A significant proportion of respondents reported working beyond internationally accepted limits for safe medical practice. About 61.8% of resident doctors reported having worked continuously for more than 36 hours. Additionally, 63.7% reported rarely or never receiving mandatory rest following 24-hour duties," mentioned the report, indicating persistent violation of humane duty scheduling principles and raise serious concerns regarding resident fatigue, patient safety, medical errors, and burnout.
Further, the survey also identified alarming levels of psychological stress among resident doctors. The findings revealed, "Approximately 87.5% of respondents reported symptoms of burnout. Sleep deprivation was highly prevalent, affecting nearly 87.8% of participants. Furthermore, 54.4% of respondents had considered leaving residency due to stress and workload. One of the most concerning findings was that 16.9% of respondents reported thoughts of self-harm related to work stress. These findings highlight the urgent need for structured mental health support systems for resident doctors."
Regarding the issue of staffing and work environment, the survey findings mentioned that a major proportion of resident doctors reported inadequate staffing in their departments. Approximately 65.7% believed there was insufficient staffing support. Similarly, 66.1% described their workload as high or extremely high.
Further, the survey highlighted the stress faced by resident doctors due to the bond policy. "Several residents reported extremely high financial penalties for leaving postgraduate seats. The inconsistency in stipend structures across institutions and states further contributes to dissatisfaction and psychological stress," the findings revealed.
The resident doctors strongly advocated for rationalization of bond policies, uniform stipend structures, timely stipend disbursement, and reduction in punitive financial burdens.
Many resident doctors reported lack of awareness regarding mental health support systems. Additionally, concerns regarding workplace toxicity, harassment, and absence of transparent grievance mechanisms were frequently highlighted.
"The prevalence of burnout, sleep deprivation, excessive working hours, and psychological stress demonstrates systemic deficiencies in residency training structures. Continuous work shifts exceeding 24–36 hours compromise not only resident wellbeing but also patient safety and quality of healthcare delivery. International residency systems increasingly recognize the importance of regulated duty hours, mandatory post-duty rest, mental health support, and structured supervision. However, many Indian institutions continue to function with inadequate staffing and excessive reliance on resident labor," the report mentioned.
It further added that "The findings of RMS 2.0 align with previous concerns raised by the National Task Force (NTF) on Mental Health and highlight the urgent need for policy implementation rather than mere recommendations. Furthermore, bond-related stress and inconsistent stipend structures contribute substantially to emotional and financial burden among residents."
The survey findings has recommended the implementation of a national duty hour cap for resident doctors, mandatory post-duty rest after 24-hour duties, strict prohibition of continuous duties exceeding 36 hours, recruitment of additional residents and healthcare workers to address staffing shortages, establishment of 24×7 confidential mental health counselling services in all medical colleges, creation of institutional mental health committees, transparent grievance redressal systems for harassment and toxic work culture, uniform stipend policies across states and institutions, rationalization and review of compulsory service bonds and seat-leaving penalties, resident participation in duty roster planning and institutional decision-making, periodic audits of resident workload and duty schedules by regulatory authorities. implementation of anti-harassment and workplace safety protocols, infrastructure development to support increase in resident doctors and PG seats for mental health friendly work schedule, and strengthening of Peripheral Health Services to reduce load on Tertiary Care Institutes.
"The findings strongly support the urgent implementation of humane duty regulations, mental health support systems, staffing reforms, and financial policy rationalization. Resident doctors are not merely a workforce resource but the future backbone of healthcare in India. Protecting their well-being is essential for maintaining both quality medical education and safe patient care," mentioned the report.
