Stress of postgraduate medical students

Dear Editor, We were fascinated with the Letter to the Editor titled “Stress of postgraduate medical students—A myth or a reality?” by Bal and Nijhawan in the January–April 2025 issue of the Industrial Psychiatry Journal.[1] They have highlighted the academic pressures and perceived stress postgraduate medical students face. We want to add that it is important to note the factors beyond academics contributing to this objective and/or perceived stress. Beyond the academic pressure of publications, presentations, and the endless studying that comes with the territory, postgraduate medical students must face the pressure of leaving their homes, acculturation, and adjusting to hectic work schedules. Sleep deprivation is a major issue, having a significant impact on one’s health, and has been associated with impaired reasoning and performance and an increase in medical errors.[2,3] Students are required to put in grueling hours of work, impacting their food habits. It is not uncommon for students to thrive on caffeine and resort to one quick meal in the day, whenever time permits. Some demands upon the students come from a culture that promotes the idea “if I went through it, so should you.” A significant decline in empathy has been noted among medical students,[4,5] which can also impact how they view and treat their patients, seniors, and subordinates, leading to an unhealthy workplace environment. In addition to the high-stakes nature of the job, other stressors that students have to face include financial strain, physical and mental exhaustion, burnout, anger, irritability, sleep disturbances, and substance use, among others.[3] In addition to early professional counseling and promoting physical activity, improving access to mental healthcare support is also important. The stigma surrounding mental healthcare, even among medical professionals, must be tackled by increasing awareness, fighting myths, and providing basic care by making mental health support more accessible, affordable, and a part of the training program, such that students are required to meet a counselor for regular evaluation for timely intervention. In addition, peer mentorship, possibly between seniors and juniors, is also beneficial in promoting empathy and compassion and building a more cohesive workplace while maintaining workplace hierarchy and boundaries. The stress postgraduate medical students face is multifaceted and influenced by multiple factors. While tough love may be important in a high-stakes profession such as this, encouraging a shift in attitude to one of empathy and understanding while fostering a more supportive environment at all levels will ultimately benefit medical students’ efficiency, learning, and well-being. Authors’ contributions Concept, design, literature search, manuscript preparation, and editing: DM, SG. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.