In the bustling corridors of hospitals, there’s a silent crisis that health care providers (HCPs) and young doctors like me face every day. It’s not the shortage of medicines or lack of equipment; it’s the unspoken suffering that I, along with countless other trainee doctors, endure in a system meant to nurture us.
Instead, this system often grinds us down, eroding our spirit and testing our resilience. It’s a crisis of immense proportions, slowly consuming the very backbone of our healthcare system: the resident doctors.
The recent tragic death of a postgraduate trainee at RG Kar Medical College and Hospital in Kolkata has cast a harsh spotlight on the systemic failures plaguing our medical institutions.
The young woman’s horrific murder while on duty has sent shockwaves through both the medical community and the country. Yet, beyond the headlines, there lies a deeper, more pervasive issue.
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Most HCPs (about 75% of doctors, according to this 2018 study) have faced violence at work and have not received help when they needed it: the mob in the emergency room, a violent relative of the patient, violent threats on the phone, the endless jibes on social media.
I echo the sentiments of my colleagues when I say that every time a doctor endures abuse in silence, a piece of their spirit is chipped away. The trauma we carry from witnessing death, disease, and the gruesome reality of our work is compounded by the abuse we endure. We may wear a mask of professional resilience, but behind it lies a deeply unacknowledged trauma that festers beneath the surface.
'A Pattern of Disrespect That We Endure'
I remember a particularly harrowing incident from this year:
I was in the Emergency Room when a male patient, despite multiple reassurances and clear instructions, kept insisting on a genital examination. It was degrading and demoralising.
We try so hard to maintain professionalism, but there are times when the boundaries of respect are continually breached. It’s not just an isolated experience; it’s a pattern of disrespect that too many of us endure.
The hostile environment doesn’t stop at the Emergency Room doors. The scariest part of a night shift isn’t the darkness of the hospital – it’s the lack of security and the absence of a systematic, secure environment that we should be provided at the workplace.
A senior recalls an incident when one night, after a particularly tense shift, one of the angry patient attendants followed her back to the resident doctor hostel. She had to hide in a friend’s room and call for help, her heart pounding with fear. The realisation that we weren't safe even in what should have been a refuge was a terrifying reality to accept.
Each time I find myself sprinting between floors at 2 am on a night shift, the unsettling quiet, the loneliness, and the creeping unease – all feed into an overwhelming sense of fear.
I try to brush it off, convincing myself it’s just hyper-vigilance – a burden women are often conditioned to develop. But now, I think of the young resident doctor from Kolkata. Did she also dismiss that gnawing fear before her worst nightmare came true?
An Unsafe Residency
The term 'resident doctor' originated in the 19th century when medical trainees began living in hospitals as part of their training. This practice was pioneered by Dr William Stewart Halsted, who established the residency program at Johns Hopkins Hospital in 1889.
Halsted believed that living in the hospital was essential for doctors to master their skills and knowledge – a belief grounded in his remarkable ability to work for days on end without fatigue.
Today, the tradition of long, grueling shifts continues, with doctors often working up to 36-48 hours straight. While Dr Halsted’s vision was revolutionary, the continued enforcement of such demanding schedules raises critical questions about whether this outdated model of training truly benefits modern medicine or merely perpetuates a legacy of exhaustion and unrelenting pressure.
The toll extends beyond mental strain; many resident doctors contract diseases like tuberculosis, dengue, and malaria while working in hospital wards, often having to show up to work while still sick.
In many Indian institutions, the basic requirement of residency – a place to rest – is not guaranteed. Some hospitals don’t even have proper rooms for us to reside in during those hectic nights.
We sometimes cannot find even one proper on-call room or duty doctor’s room and are left scrambling to find a horizontal space to straighten our spines. The last thing we want to worry about is our safety.
But we do. I’m not alone. Many women work night shifts at hospitals –doctors, nurses, lab technicians, janitors.
When some of us finally find the time and space to rest our heads, when the whole world is sleeping, we imagine it’s safe to do so.
As the tragedies in Kolkata, Moradabad, and Dehradun unfolded, we learned that it isn’t. If resident doctors can’t be guaranteed a safe place to work, how can we expect them to be present at the hospital, let alone endure relentless shifts while pushing through their physical exhaustion?
The constant pressure to perform under extreme conditions, coupled with the fear of violence, contributes to a pervasive sense of dread and anxiety.
A fellow doctor recounts her personal struggle:
“I’ve had nights where I couldn’t sleep, haunted by the fear of violence or harassment. The mental burden is as heavy as the physical demands. Yet, when we seek help or express our concerns, we are often met with indifference or accusations of weakness.”
'Our Fight Isn’t Just for Better Working Conditions'
The crisis faced by trainee doctors in India is a multifaceted issue that demands urgent attention. The current system, with its inadequate safety measures and exploitative practices, is failing those entrusted with the responsibility of healing others.
Expecting doctors to work in unsafe conditions while bearing the brunt of patient fury is tantamount to asking them to sacrifice their well-being on the altar of medical duty.
There are tangible steps that can be taken to address these issues. Enhanced security measures within hospitals, including well-trained security personnel and emergency protocols, are essential.
Additionally, improving infrastructure to provide safe spaces for rest and breaks, and ensuring adequate staffing levels, can alleviate some of the burdens faced by trainee doctors.
While the conversation about exempting female doctors from night shifts has begun, is this really a solution to the ongoing problems we face? Wouldn't this deprive us of the training we require as resident doctors? Are crimes against HCPs not occurring in broad daylight? Instead of creating safe spaces, we are further limiting women HCPs in their workplaces.
The silent suffering of doctors and healthcare providers isn’t just a symptom of overwork – it’s a call for urgent reform and a demand for respect in the face of adversity.
Our fight isn’t just for better working conditions; it’s for a system that acknowledges our humanity and treats us not merely as instruments of care but as individuals who deserve safety, dignity, and support. When we are dehumanised and pushed to our limits, it’s not just us who suffer – the entire healthcare system falters, and patients ultimately pay the price.
(Dr Vasudha Mishra is a medical graduate from All India Institute of Medical Sciences (AIIMS) Patna. She is currently practising medicine in Mumbai.)
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