Over 35% of Doctors, Predominantly Women, Report Feeling Unsafe on Night Shifts: IMA Study

One-third of doctors, mostly women, feel unsafe during night shifts, according to an Indian Medical Association (IMA) study. Some even carry weapons for self-defence. The survey, conducted online, involved 3,885 respondents and is the largest of its kind in India. It was undertaken following the alleged rape and murder of a trainee doctor at RG Kar Medical College and Hospital in Kolkata.

The survey revealed that 45% of respondents lacked access to a duty room during night shifts. Those with duty rooms often found them 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 Concerns Among Young Doctors

Doctors aged 20-30 years, mainly interns and postgraduates, reported the lowest sense of safety. 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.

Dr Rajeev Jayadevan, Chairman of the Research Cell at Kerala State IMA, compiled the findings with his team. These findings will be published in the Kerala Medical Journal's October 2024 issue. The respondents came from over 22 states, with 85% being under 35 years old and 61% being interns or postgraduate trainees.

Infrastructure and Security Issues

The survey highlighted several infrastructure issues that contribute to safety concerns. Nearly one-third of duty rooms lacked attached bathrooms, forcing doctors to step outside during late hours. Additionally, more than half of the duty rooms were located far from patient care areas.

Doctors suggested various measures to enhance safety. These included increasing trained security personnel, installing CCTV cameras, ensuring proper lighting, implementing the Central Protection Act (CPA), restricting bystander numbers, installing alarm systems, and providing secure duty rooms with locks.

Experiences of Threats and Violence

Many doctors reported verbal and physical threats from individuals who were drunk or under the influence of drugs. One 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. Doctors also reported apathy from administrators when raising security concerns. A common excuse was that senior doctors had endured similar conditions.

Calls for Policy Changes

The survey findings have significant implications for policy changes. Doctors across India have called for a Central Protection Law to prohibit violence in healthcare settings and enforce airport-like security measures. Such a law would standardise security arrangements across the sector.

The Supreme Court of India has taken suo motu cognisance of these concerns, assuring that doctors' safety issues are receiving high-level attention. 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 study underscores the urgent need for better security measures in healthcare settings to ensure both doctors' safety and improved patient care.