It seems to be a never ending wait for patients at Post-Graduate Institute of Medical Education and Research (PGIMER), the premier institute in the North, where it is becoming increasingly difficult to find a place to even stand. According to the PGI administration, about 9,500 patients visit the OPDs every day. In 2018, the total number of patients in the OPDs was estimated at 28,69,150 compared to 26,84,508 in 2017. This represents a massive rise from the OPD count of 1,25,163 and 1,72,606 in 1963 and 1964 in the dawning years of PGI. The indoor admissions now stand at 1,874 a day.

Manmohan Singh, a resident of Barnala, waiting for his turn to show his four-year-old son’s eyes at the Advanced Eye Care Centre said that his son has a vision problem since birth and they had showed him at a local hospital where they were advised to visit PGI Chandigarh. He mentioned that it was a long wait at PGI Chandigarh and his young son was getting restless.

The patient overload is leading to long queues for treatment and is putting a huge pressure on doctors and healthcare infrastructure of the institute. The premier institute, which was set up to undertake research, is finding it difficult to cope with an outpouring of patients from as far as Jammu and Kashmir in the north to Bihar and Manipur in the east.

During its inception in 1963, the directive of the PGI was to develop teaching patterns in postgraduate medical education and to meet the country’s need for highly qualified medical teachers. It aimed to provide educational facilities for training of personnel in all the important branches of health activity and undertake community-based research. However, with a decline in health services in the region, the institute has been increasingly limited to patient care, at times providing treatment that can be delivered by even a dispensary.

The highest number of OPD patients at PGIMER comes from Punjab. It also receives patients from Uttar Pradesh, Haryana, Himachal Pradesh, Uttarakhand, Jammu and Kashmir and various other states.

A research conducted by Dr Sandeep Grover of the Psychiatry department found that doctors at PGIMER are suffering from depression, stress and burnout. Among 1,607 eligible participants, 376 respondents (77.75%) were resident doctors and 69 (15.5%) were faculty. The majority of the respondents were men and the mean age of the sample was 31.63 years. The mean age of the residents included in the study was 28.93 years and that of faculty was 46.36 years. Nearly 30.1% of the participants were found to suffer from depression and 16.7% reported suicidal ideations. About two-thirds of the sample reported moderate level of stress while 13% reported high levels of stress. More than 90% of the participants reported some level of burnout.

Compared to faculty, a higher proportion of the residents reported stress, depression, and burnout. Presence of depression, stress, or burnout was found to be associated with lower indulgence in recreational activities, experiencing verbal or physical abuse at the hands of patients/caregivers, and feelings that seniors do not show empathy toward patients.

About 65.2% of the respondents were from medical stream, 26.7% from the surgical stream, and 8.1% from the paramedical stream. There was a slight predominance of married professionals (52.6%) in the sample. Those married were mostly staying with their spouses (70.9%) and those unmarried usually did not have a steady partner (61.6%). The mean number of working hours during the last week for the respondents was 76.76 hours. The working hours were significantly higher for the residents compared to the faculty.

The findings from the study highlighted an urgent need to develop mechanisms to evaluate and address work-related stress, burnout, and depression among doctors. The study also stated that there is a need to equip the medical professionals with skills of stress management and check the stigma associated with mental disorders so that these professionals can seek help when required. The stress management skills should focus on an array of behavioral and cognitive strategies. At the institute level, there must be regular screening of a professional’s mental health and regular stress management workshops should be conducted.