Authors
Rajeev Jayadevana, Deepa Augustineb, Anithadevi TSc, Reshmi Ramachandrand, Joseph Benavene
aChairman, Research Cell, Kerala State IMA; bAssociate Professor, Deparment of Dermatology, Government Medical College, Ernakulam; cBiostatistician, Aster Medicity, Kochi; dAssociate Professor, Department of Community Medicine, Government Medical College, Kottayam; ePresident, IMA Kerala State Branch
Abstract
Background: Reports of violence against doctors at the workplace are on the rise. In August 2024, a young female doctor was raped and murdered during night duty at her workplace in Kolkata, India. This incident prompted nationwide protests and a service shutdown by doctors’ organizations advocating for improved workplace safety.
Aim: This survey was undertaken by the Indian Medical Association to evaluate safety concerns during night shifts among doctors. With 3,885 individual responses, it is the largest study from India on this topic.
Methods: An online survey was sent to doctors across India through a Google form. There were 3885 responses. In addition to seeking suggestions to improve safety, three separate parameters were assessed:
1. 0-10 numeric rating scale of perception of safety
2. Availability of duty room
3. Access to bathroom while on night duty
Results:
1. Respondents were from several states. 85% were under 35 years. 61% were interns or postgraduate trainees. Women constituted 63%, aligning with the gender ratio in some MBBS courses.
2. Several doctors reported feeling unsafe (24.1%) or very unsafe (11.4%), totalling one-third of the respondents. The proportion of those feeling unsafe was higher among women.
3. A duty room was not available to 45% of respondents during night shifts.
4. Those with access to a duty room had greater sense of safety.
5. Duty rooms were often inadequate due to overcrowding, lack of privacy and missing locks, forcing doctors to find alternative rest areas.
6. One-third of available duty rooms did not have an attached bathroom.
7. In more than half the instances (53%), duty room was located far from the ward/casualty area.
8. Suggestions to enhance safety included increasing the number of trained security personnel, installing CCTV cameras, ensuring proper lighting, implementing the Central Protection Act (CPA), restricting bystander numbers, installing alarm systems, and providing basic amenities such as secure duty rooms with locks. For detailed information, refer to Table 12, the synopsis and the verbatim comments section.
Conclusions: Doctors across the country, particularly women, report feeling unsafe during night shifts. There is substantial scope for improving security personnel and equipment in healthcare settings. Modifications to infrastructure are essential to ensure safe, clean, and accessible duty rooms, bathrooms, food, and drinking water. Adequate staffing, effective triaging, and crowd control in patient care areas are also necessary to ensure that doctors can provide the required attention to each patient without feeling threatened by their work environment.