Most young women doctors working in govt hospitals feel unsafe during night shifts: IMA study

NEW DELHI, AUG 29 : Over one-third of Indian doctors, primarily young women, working mainly in government hospitals feel unsafe while doing night duty found the latest survey conducted by the Indian Medical Association (IMA).

The study found that the doctors feel unsafe in the absence of duty rooms without bathrooms, insufficient untrained security staff, inadequately lit corridors, no CCTV cameras, and unrestricted entry of unauthorised individuals into patient areas.

As many as 3,885 doctors – 63 per cent women – in 22 states, including Kerala, Karnataka, and Tamil Nadu, were surveyed by IMA. The largest organisation of medical professionals with over 4 lakh members, surveyed the doctors about their safety concerns during night duty in the wake of nationwide protests by resident and junior doctors over the alleged rape and murder of a trainee woman doctor in a state-run hospital in Kolkata.

“The survey conducted among 3,885 doctors found that 24.1 per cent felt unsafe during duty hours and 11.4 per cent considered their situation very unsafe, with 35.5 per cent feeling unsafe to various degrees,” it found.

It also said that women report higher levels of feeling unsafe or very unsafe (36.7 per cent) compared to men (32.5 per cent). Doctors in the age group of 20-30 years, largely interns and postgraduates, report the lowest sense of safety.

The survey confirmed that violence is predominantly experienced by junior doctors, who, being on the frontline, are particularly vulnerable but have limited involvement in administration or policymaking.

The situation worsens in some smaller hospitals with limited staff and no security.

According to Dr Rajeev Jayadevan, the survey’s lead author, the study is unique not just because it is the largest of its kind in India, but also because it analyses over ten thousand specific observations and suggestions from doctors across 22 states.

“Crime thrives when conditions support it, and the study highlights the inadequacy of various safety arrangements for doctors on night duty in all settings. Young women are the most affected, and the findings broadly apply to all women working night shifts. The details provided in the study will serve as a valuable reference for policymakers,” Dr. Jayadevan, Chairman of Research Cell, Kerala State IMA, told TNIE.

“Night shifts increase doctors’ vulnerability to violence due to reduced staff, the cover of darkness, and the presence of individuals under the influence of alcohol or drugs. Factors such as the lack of dedicated and secure duty rooms, their distance from the workplace, and the need to walk a significant distance to access facilities further heighten their risk,” the study said.

“Women doctors face greater risks in these situations,” the survey said, adding that they prefer ex-servicemen as security guards and abled-bodied young men as bouncers in high-risk areas such as casualty and ICU lobbies where skirmishes are common.

Some women doctors even suggested female security personnel, a security escort at night when they have to visit various areas during night duty, a panic button, emergency helpline, or specialised alarm system to summon immediate assistance, which is known as code grey or code white in various facilities, in times of distress.

Such is the fear that a woman doctor even admitted that she always carried a foldable knife and pepper spray in her handbag because the duty room was located at the far end of a dark and deserted corridor.

The survey said if steps are not taken to stop violence against doctors, it could lead to hesitancy among them not to undertake potentially risky life-saving procedures, or they may prefer to refer patients to other centers.

Most doctors were emphatic about needing a CPA or Central Protection Act that enables them to work safely in any healthcare establishment and file an FIR on time.

The survey also found that duty rooms, which give doctors a sense of security, were often inadequate due to overcrowding, lack of privacy, and missing locks, forcing doctors to find alternative rest areas – as was done by the 31-year-old woman doctor in Kolkata, who after working for 36 hours took rest in a conference room and was subsequently found raped and murdered.

The survey found that 55.2 per cent of doctors in India have access to duty rooms, while 44.8 per cent do not have such facilities.

Of the 2,145 participants with access to a duty room, 67.6 per cent reported having a duty room with an attached washroom, while 31.4 per cent did not have this facility.

In nearly 53 per cent of cases, doctors’ duty rooms were far from their ward/casualty.

“A majority of doctors must walk a significant distance from their duty rooms to reach the ward or casualty area, which can pose a safety risk at night if the path is not well-lit and secure,” the survey said.

This shows that the availability of a duty room significantly impacts safety perceptions, with those without access feeling unsafe (50.9 per cent) compared to those with a duty room (22.9 per cent).

Similarly, a duty room with an attached washroom is associated with better safety perceptions; more of those without such facilities feel unsafe (44.8 per cent) compared to those with the facility (20.2 per cent). Similarly, more of those with an attached washroom felt safe (30 per cent) compared to only 10.8 per cent without.

Of the 3885 doctors, 80 per cent were junior doctors. While the majority were postgraduates (1619), it was followed by interns (750), junior doctors working in government hospitals (407), and junior doctors working in private hospitals (332).

“Healthcare professionals are required to take night shifts as part of their training during internships and postgraduate studies, and they continue to work night duties in both private and public sectors throughout their careers. This aspect of the profession makes them vulnerable to various forms of workplace violence,” the survey said.

“In crowded settings like outpatient facilities, emergency rooms, or ICU waiting areas, doctors on the frontline are particularly vulnerable to sudden and unprovoked attacks. Perceived or real deficiencies in healthcare delivery, adverse outcomes, payment disputes, and substance abuse can trigger violence,” it said.

While most instances of violence are spontaneous, some cases, such as the recent incident in Kolkata, are intended, it added.

The findings come even as the National Task Force (NTF), set up following the Supreme Court order, has directed states and union territories to provide safety and security for doctors.

-PTI