1. Mental health among trainee anaesthesiologists in a South Indian tertiary care hospital
W.Rajaleelan, S.Rajaleelan, B.Kuppswamy, Samuel K.
Department of Anaesthesiology, Psychiatry, C.M.C Hospital, Vellore
Introduction
Methodology
Results
Conclusions
Anaesthesia is an extremely stressful specialty with high levels of burnout, substance use and suicide rates. (Simms et al, Canadian Journal of Anaesthesia)
Among medical professionals anaesthesiologists have a higher rate of suicide. (Swanson et al, Anaesthesia Intensive Care)
The practice of anaesthesia in India is different from abroad, with more stress probable due to variation in quality of facility available, high work load, poor remuneration, dependence on surgeon…
However very few studies from Indian setting looking at this issue.
High levels of burnout and chronic stress due to sleep deprivation among anaesthesiologists in a South Indian hospital (Koshy et al, IJA)
71% felt over worked
50% felt under appreciated for their services
High prevalence of stress related ailments like acid peptic disease, hypertension, chronic backache and diabetes mellitus.
Study design: Cross-sectional
Study location: Department of Anaesthesia, Christian Medical College, Vellore
Inclusion criterion: All anaesthesiology postgraduate registrars – doing either D.A. or M.D. who consented to participate
Exclusion criteria: Refusal to consent
Instrument administered: General Health Questionnaire -28
Screening tool to pick up higher levels of emotional distress, risk for psychiatric illnesses
Well validated tool, widely used, available in 38 languages
English, self administered
Participant break down:
Total no. of registrars in the department: 34
No. present on the day of testing: 30
No. who refused consent: 2
Total Participants in study: 28
• Background characteristics:
Gender – 61% female
- 39% male
Age % < 30 yrs
- 43%> 30 yrs
- Rest missing (1 person)
GHQ scores:
Mean score: 24.73(Std dev = 11.29)
GHQ cut-off = >23 for emotional distress
Percentage above GHQ cut-off: 43%
Risk Factors for emotional distress:
Female gender, Chi square test= , p value = 0.001
Age< 30 yrs, Chi square test= 6.99, p value =
The prevalence was higher in females as compared to male registrars – agrees with higher rates of depression, burnout in women.
Higher prevalence in age group < 30 yrs surprisingly, probably due to longer years of study ahead.
Study indicates significant levels of emotional distress in anaesthesia post graduates.
Global research on emotional well being of doctors burgeoning.
Anaesthesia receiving attention as a vulnerable specialty
Research and awareness in India on this issue, needs to grow.
Limitations:
Smaller sample size
Cross sectional study design
Results may be influenced by current frame of mind, though questionnaire specifies one month period
References
Simms M, Stevens SM, DayA, McKeen D. Anaesthesia resident stress: Implications for Canadian postgraduate training programmes. Can J Anaesth 2008;55: Suppl1:   
Swanson SP, Roberts LJ, Chapman MD. Are anaesthetists prone to suicide? A review of rates and risk factors. Anaesth Intensive Care2003;31:
Koshy R, Ramesh B, Khan S, Sivaramakrishnan A. Job satisfaction and stress levels among anaesthesiologists of south India. Indian Journal Anaesthesia 2011; 55:
Hawton K, Clements A, SakarovitchC, Simkin S, Deeks JJ. Suicide in doctors: A study of risk according to gender, seniority and specialty in medical practitioners in England and Wales. J Epidemiol Community Health2001;55:
Murray D, Dodds C. The effect of sleep disruption on performance of anaesthetists: A pilot study. Anaesthesia 2003;58;520-5
Larsson J, Rosenqvist U, Holmstrom I. Being a young inexperienced trainee anaesthetist: A phenomenological study on tough working conditions. ActaAnaesthesiolScand 2006;50:653-8.  
Kinzl JF, Knotzer H, Traweger C, Lederer W, Heidegger T, Benzer A. Influence of working conditions on job satisfaction in anaesthetists. Br J Anaesth 2005;94:211-5.
Objectives
Risk Factor
Chi square
P value
Female
gender
10.539
0.001
Age<30yrs
6.99
0.008
To assess mental well being in a group of trainee anaesthesiologists
• To look for risk factors that are associated with lower levels of mental well being
Acknowledgements
We thank all the anaesthesiology postgraduates, who enthusiastically participated in the study despite their hectic schedules.