One-third of doctors, mostly women, felt ‘unsafe’ or ‘very unsafe’ discharging their duties during night shifts, revealed a first of its kind mega excercise carried out by Indian Medical Association (IMA) in wake of the recent rape and muder of a trainee doctor at RG Kar Medical College and Hospital in Kolkatta. Some medicos also revealed of carrying weapons for self-defence like folding knife, pepper spray, etc. The survey, conducted online, involved 3,885 respondents and is considered presently the largest survey of its kind in India also.
As per the survey findings, a significant 45% of respondents revealed lack of access to a duty room during night shifts. Those with duty rooms often found the surroundings overcrowded, lacking privacy or without locks. In many cases, these rooms were far from the ward or casualty area, and one-third did not have attached bathrooms.
Safety issues faced by doctors
Survey participants mostly aged between 20 years to 30 years, mostly interns and postgraduates, confessed the maximum about unsafe working conditions. Women constituted 63% of respondents, reflecting the gender ratio in some MBBS courses. A total of 24.1% felt ‘unsafe’, while 11.4% felt ‘very unsafe’.
The survey findings compiled by Dr Rajeev Jayadevan, Chairman of the Research Cell at Kerala State IMA and his team would be published in the Kerala Medical Journal’s October 2024 issue. The respondents are located over 22 states, with 85% being under 35 years old and 61% being interns or postgraduate trainees.
Safety concerns about infrastructure and security
The survey highlighted gross infrastructure laxities generating safety concerns like around one-third of duty rooms lacked attached bathrooms, forcing doctors to step outside during late hours. Also, more than half of the duty rooms were located far from patient care areas.
Enhanced safety measures demanded
Online respondents to the survey suggested various measures to address safety issues which included increasing trained security personnel, installing CCTV cameras, ensuring proper lighting, implementing Central Protection Act (CPA), restricting bystander numbers, installing alarm systems, and providing secure duty rooms with locks.
Doctors reveal several threats and violence incidents
Many doctors reported verbal and physical threats from individuals who were drunk or under the influence of drugs. One lady doctor mentioned carrying a foldable knife and pepper spray due to the isolated location of her duty room. Another doctor experienced inappropriate contact in a crowded emergency room. The situation is worse in smaller hospitals with limited staff and no security.
Survey revealed reports of apathy from administrators when security concerns were raised by hapless doctors on night shifts. A common excuse that was communicated to complaints by night shift junior doctors was that senior doctors had also endured similar conditions.
Central Protection Law, airport-like security demanded
The survey findings revealed demand for policy changes by doctors from all over the country. A Central Protection Law to prohibit violence in healthcare settings and airport-like security measures were some of their demands. Doctors felt that Central Protection Law would standardize security arrangements across the sector.
The Supreme Court of India took suo motu cognisance, assuring that “doctors and medical professionals shall stand assured that their concerns are receiving the highest attention from the highest court, with input from a diverse range of experts”.
The Government of India has already addressed some policy changes in response to the Kolkata incident. Senior faculty members are responsible for implementing policies to improve patient care delivery and enhance security measures.
This would create a safer work environment for junior doctors who are particularly vulnerable but have limited involvement in administration or policy-making. The IMA survey underscores the urgent need for better security measures in healthcare settings to ensure both doctors’ safety and improved patient care.
