Dr A S Bhatia
Junior Doctors are a vital and intrinsic part of Healthcare delivery System all over the world but since long this mobile national workforce was shouting and screaming about being overworked, undervalued, demoralized, and fatigued. This is the true global picture of Junior Doctors whether it is America, UK, South Korea or any other country on the global map! Lack of properly defined working hours, lack of leave entitlement, which is applicable to other profession, were the most discouraging things for the new younger generation to go for the White Coat! I did my junior residency in the department of surgery and medicine in the mid 1980s and even in those days when the work load was not that voluminous, as is of today, we used to work in wards for 72 hours at stretch and most of the time had to go without food and bath for days together! A physically and mentally fatigued doctor cannot deliver the best to the patients. As the world renowned professor, Dr Genevieve Yates while chairing the RACGP Expert Committee said, “The risk of making mistakes due to fatigue is “extremely significant”, “It’s really worth noting that fatigue is such a dangerous thing when it comes to performance’, she said, “If you have been working for 18 hours, you are performing at the equivalent of a blood alcohol level of 0.05- so pretty much on the limit of being impaired. “If you spend 24 hours without sleep, it’s closer to a 0.1 blood alcohol level.” “There’s no way that we would let our doctors work while drunk, and yet, essentially via fatigue, that’s exactly what we’re doing.”
One of Junior doctors in GMC Rajouri told me, “Sir, People don’t realize the reality of being a Junior Doctor, we are working day in and day out without any break, have to face the wrath of the people in the emergency ward, we are being emotionally drained and many of my friends are suffering from panic attacks, migraine, feeling demoralized and are becoming patients because of excessive stress, we too need a break as ‘All work and no play will make Jack a dull boy.” I could see the helplessness in the eyes of my Junior Doctor and wished something could be done to improve their work culture! I have seen many Junior Doctors Association of many prestigious institutes of the country and abroad in the past demanding reforms and also resorting to strikes for pressing their demands but till date their cries went unheard!
The Dream of the Junior Doctors of J&K came true when, Health and Medical Education Department of UT of Jammu and Kashmir, perhaps the first among many few in the country, came to the rescue of overburdened, overworked, undervalued, fatigued Junior Doctors, which in a major step to bring reforms in the working condition of Junior doctors issued an historical order on 8th of July 2024 about leave entitlement for post graduate students and senior residents/tutors/ DNB and post graduate students working in Government Medical Colleges of Jammu and Kashmir. As per this order now there shall be weekly one day off. In addition, all junior doctors shall be eligible for twenty days casual leave, Five days Academic leave. Female Junior Doctors shall be allowed Maternity Leave, MTP/Abortion leave and Male doctors shall be allowed paternity leave. This order issued by Health and Medical education department will prove to be a path breaking decision in improving the working conditions in the hospitals especially Emergency wing and will also help in improving the morale of the young medical force.
This order may look like any other ordinary order issued by the administration, to the common masses, but the beauty, fragrance and self respect this order will bring in the life of junior doctors can be felt only by those who have worked as junior doctors once in their life time! About twenty five years back I was doing my post graduation in Mahatma Gandhi Institute of Medical Sciences Sevagram, Wardha, Maharashtra and Harleen, my life partner, was pursuing her post graduation in the same institution, and during our studies we were blessed with a son. We were now having two kids, one my daughter, along with pursuing our professional dreams to excel in the field of medicine. But the agony we had to undergo had left us broken many times. We used to lock our children in our rented room under the supervision of a Marathi women care taker and after every four hours I used to take the baby on motorcycle to the hospital in the ward, where Harleen was performing her duties, to get the new born fed! I can never forget the scene of my wife feeding the child in the corridors of hospital ward and with tears in her eyes looking towards me, as silently she was asking , “Why this torture to me and my child, let me leave my PG course” and truly speaking I could never gather the courage to look into her eyes! However we were continuing but the things took a sudden turn when after attending a call from emergency in the mid of night, Harleen came back to our rented accommodation at 2 AM when she saw our daughter, Sapneet, standing in the mid of lawn barefooted and ran to pick her up, but to the most horrific experience of her life saw around 8 to 10 scorpions near her.
She picked her daughter and ran towards the room screaming madly! The mental trauma was so severe that Harleen decided to leave her post graduation in the subject of ophthalmology because she was not permitted any leave to take care of her child! It was only after six months that she got selected in Post graduate course in the subject of Microbiology. This is not the story of ours, but is the story of all young medicos who have to make a balance between the family and Professional life! I wish the order issued by the Govt of J&K for Junior doctors should have been there when we were doing our junior residency! This could have faced us from mental agony, frustration, anger, resentment and would have helped us to deliver our best for the patient care!
In my write up “Reforms in Health and Medical Education” published in Daily Excelsior on July 1, 2023 I have discussed various post Covid reforms including strengthening of health care infrastructure, starting of BSc Nursing ad Paramedical colleges, starting of DNB courses and most important switching to adaptation of Rotational Headships in various departments of Government Medical and Dental Colleges of Jammu and Kashmir, which was the need of hour, as there are many examples where HoDs have occupied the chairs for nearly two decades and other despite becoming professors had never been able to head the departments and many had to retire without becoming HoDs being older in age! Continuing their mission of bringing reforms in health care delivery system and to bring best for the people of Jammu and Kashmir, The Health and Medical Education Department, led By its Secretary to Government Dr Syed Abid Rasheed Shah, deserves all appreciation for issuing this historical order of Leave entitlement for post graduate students and senior Residents/Tutors executing their assignments in Government Medical Colleges of J&K and DNB PG students, for improving the working condition of Junior Doctors, which will help in improving the quality of health care delivery system along with bringing a sigh of relief in the life of junior doctors. At least now no Junior Doctor will have to carry his newly born baby on his motorcycle to the hospital to get the baby breast fed from the Doctor Mom, who is performing her duties under severe mental stress knowing that her child is hungry ! No young doctor will have to lock their children in a room to perform their professional duties and no young doctor will have to go without food and bath for days together. Such revolutionary ideas and administrative will to implement these ideas will go a long way to improve the life of young medicos and shall bring a smile of self respect on the faces of Junior Doctors!
Otherwise as Mirza Ghalib said,
Ye khamosh mizazi
tumhe jeene nahi degi
Is daur mein jeena hai
to kohraam macha do
yaro.
(The author is Principal Govt Medical College, Rajouri)
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