India: Why many medical students are taking their own lives

In what should be the beginning of a successful career, Barnali took her entrance exam to become a medical student in India this year.

But the experience has been far from pleasant, as she explained to DW. “My parents are both doctors,” she began. “So I have always felt pressurized to take up medicine as a career. I don’t think I will qualify this year.”

She is not alone in a country that confers great respect on practitioners of the medical profession.

Students undertaking the entrance exam feel an immense amount of pressure from their families, educational institutions and society as a whole.

Rising student suicides

In the southern state of Tamil Nadu, several students took their own lives after taking the National Eligibility cum Entrance Test (NEET), before the results were even out. Local media reports said many of the students were afraid they hadn’t performed well enough in their exams, which is why they took this tragic step.

The NEET is a centralized exam conducted across India for students to qualify for the Bachelor of Medicine, Bachelor of Surgery (MBBS) course. It was introduced in 2013, mandatory for students before entering private and public medical colleges to study the MBBS degree. On average, students taking this exam are aged between 17-19 years old.

State authorities were alarmed by the high number of suicides among medical entrance candidates. Tamil Nadu’s Chief Minister MK Stalin mourned the deaths of students on Twitter.

The state launched a helpline so students can access counseling over the phone, and introduced a bill to scrap the entrance exam altogether, saying it will reduce the amount of pressure on students to perform well in a one-off assessment that determines their fate. The western state of Maharashtra is also considering scrapping the exam.

While the move is being considered as a positive one, many are worried that it will only transfer the pressure to school academic performances. India has three different educational boards: the CBSE, ICSE, and the state board, with differing educational levels and grading parameters.

“Canceling the NEET is a good idea, but it is going to make the process of getting into colleges even more competitive, based on their final grades,” Kimberley, a student who took the exam in 2019, told DW.

“The school boards have different difficult levels, so the competition seems unfair. On the other hand, it could be a good thing because only rich and privileged students who can afford private coaching for NEET have an unfair advantage,” added Barnali.

Undue pressure on students

Preeti N, a Mumbai-based counselor, told DW that students often suffer from anxiety and depression when it comes to highly competitive exams. “Students taking competitive exams, especially in a field like medicine, are often facing immense pressure from their parents, teachers, and sometimes friends. To some of them, failure is not an option. Often, their lives completely revolve around exam preparation,” she said.

“In a system where the number of entrants is so high,” she continued, “the chances of getting through are low. It can get quite suffocating. It is important to reach out to students and make them understand that there are going to be other chances, as well as alternative paths and careers.”

Studies suggest that those who do make it into medical colleges and work as doctors continue to face extreme stress throughout their careers.

A survey of 358 suicide deaths among medical students, residents and physicians between 2010 and 2019 showed around 7 out of 10 suicides happened before the age of 30. Academic stress and financial issues were the causes listed as the reasons behind the suicides.

As these professionals go on to make up the health care system of the country, the study said this was a public health crisis, and probed further research into this.

“Many medical students, residents and doctors lead a terrible lifestyle,” said Preeti. “It is one of the most stressful professions of modern times, and has become increasingly difficult due to the pandemic. Even doctors need their own private time, and a work-life balance like the rest of us. Students begin by taking tough exams, but even once they pass the test, the stress in their life continues.”