84% of undergraduate medical students experience moderate to very high levels of stress, while 64% say workload has a negative impact on mental health: survey

A file photo from NIMHANS in Bengaluru. The National Medical Commission had formed a task force headed by Suresh Bada Math, Professor of Psychiatry, NIMHANS, to conduct an online survey on the mental health of medical students across the country. | Image credit: File photo

The National Task Force on Mental Health and Well-being of Medical Students-2024 report found that 84% of postgraduate medical students experience moderate to very high levels of stress, while 64% say workload negatively impacts their mental health and well-being.

The report, based on a nationwide online survey, also showed that an “alarmingly high” proportion of 27.8% of undergraduate medical students and 15.3% of graduate medical students voluntarily reported having a diagnosed mental disorder, and that 16.2% of undergraduate medical students and 31.2% of graduate medical students reported having had suicidal thoughts.

Main stressors

They cited factors such as long working hours each day, continuous deployment days, and inadequate infrastructure and support as contributing stressors. “This highlights the need for effective stress management and mental health support structures in medical settings,” said the report, which elicited responses from 25,590 undergraduate students, 5,337 graduate students, and 7,035 faculty members.

About 19% of PG students said that they want to relieve stress by consuming substances like tobacco, alcohol, cannabis and other drugs. Therefore, there is an urgent need to take steps to educate students and also implement stress reduction measures, the report said.

Since medical education is fraught with numerous challenges including intense competition, emotional stress, financial burdens, interpersonal conflicts, limited personal time and inadequate support, creating an environment conducive to mental health problems, the National Medical Commission (NMC) has constituted a task force headed by Suresh Bada Math, Professor of Psychiatry, NIMHANS, Bengaluru. The task force conducted an online survey on the mental health and well-being of medical students across the country.

Financial worries

The study also finds a link between the high cost of studying medicine and its association with stress. Around 60.1% of the students who participated in the survey said that their stress and well-being is affected by financial worries. A large majority of 72.2% find their stipend inadequate, “indicating that the stipend policy needs to be urgently reviewed and adjusted.” While 58.4% said they receive their stipend regularly, 41.6% do not, indicating possible areas for improvement. Almost 50.7% of PG students said that their families are financially dependent.

Financial stress is also a significant problem for undergraduate students, with 33.9% of students finding their finances extremely or significantly stressful. 27.2% have student loans or debt, and 32.7% of them reported feeling extreme or significant pressure to repay.

Almost half of the PG students surveyed (45%) reported working more than 60 hours per week, with over 56% not getting weekly leave. About 38% of the PG students reported not getting enough time to rest, while 57% stated that they were denied their weekly leave as per NMC regulations.

Discrimination, a factor

“Discrimination can significantly affect the mental health, academic performance and well-being of students. However, 68.80% of PG students reported that they do not face discrimination in their academic environment on the basis of gender, ethnicity, religion, caste, geography, language or any other factor. At the same time, however, a significant percentage (31%) of students reported that they experience discrimination. This highlights the need for institutions to take stronger measures against discrimination and promote an inclusive environment,” the survey report said.

A significant number, 18% of PG students, reported that bullying still occurred and was hurtful to them. “This highlights the ongoing problem of bullying in some academic settings. About 27% reported being bullied in clinical settings by senior PG students, while 31% reported similar experiences with faculty and senior residents.”

Fear of failure

Many highlighted that fear of failure leads to a variety of negative behaviors, including procrastination in 52.5% of UG students, skipping classes or assignments in 7.6%, excessive perfectionism in 6%, thoughts of dropping out in 2.9%, and thoughts of self-harm in 1.3%. “These findings underscore the significant academic pressure and stress faced by medical students,” the report said.