Underpaid and overworked: What keeps young medicos on COVID duty going

“After a point, I made peace with my fate. If I die, I die,” says Akshay*, a 24-year-old doctor who is on duty at a COVID-19 ward in a government hospital in Madhya Pradesh.

He was unsure of working amid the COVID-19 pandemic as his mother had a history of respiratory failure. Akshay feared that her life would be at risk if he came in contact with COVID-19 patients. He even took a break when Madhya Pradesh witnessed a spike in cases, but was issued a notice to join the duty as soon as possible.

However, Akshay who is on the ground, visiting people suspected of having COVID-19, and treating and counselling them, has no regrets.

Like Akshay, lakhs of postgraduate medical students, interns and freshers, who are yet to receive their medical licenses, have been roped in to fight the pandemic. The young medicos, who are on the frontlines of efforts like other senior doctors, are doing what they are ‘supposed to do’ without much expectations from the government.

Justice to the job

“It’s been three months since I joined Brihanmumbai Municipal Corporation (BMC) as an Assistant Medical Officer. I have not been paid a single penny,” says Dr Dharam. “But, I have no complaints,” he adds. Dharam, who lives in Dharavi, is the sole breadwinner of his family. Dharam’s father had shut his shop three months ago due to the lockdown.

“I won’t deny the fact that I don’t have financial issues. I do. But, if I sit and sulk about it, I will not do any justice to my job. Right now, doing my job is the priority. I don’t want to blackmail the government regarding irregular pay or anything else for that matter,” says Dharam.

Concurring with Dharam, Anuj Nayak, another Mumbai-based junior doctor, says he will continue to serve no matter how much the hospital pays him. “It is true that I am not being paid, but if I say no, then who will do my job?” he asks.

However, some young doctors do feel that the current pay is not justified, considering their efforts to fight the pandemic.

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“Pay is a mere joke. Firstly, I am not being paid. Secondly, even if I am paid, I don’t think the wage is justified. Wearing PPE throughout the day feels like I am on fire. For putting our lives at risk, the least the government can do is pay us,” says Chandana, a Haryana-based junior doctor. Chandana is yet to receive her two-month salary.

Some young medicos The Federal spoke to feel that the stipend given to interns in Tamil Nadu is far less when compared to other states. “Stipends given to doctors here (in Tamil Nadu) is the lowest among all states. The last hike we got was five years ago,” says Aravind, a postgraduate student who is currently on COVID-19 duty in Chennai.

Agreeing with Aravind’s remark, another postgraduate student in Chennai, Ahimth, says interns in the state get their stipends only after six months. “This is the main issue in Tamil Nadu. This has been continuing for years now,” he says.

The scene is different in Mumbai’s hospitals. Interns had to fight with the administration to get paid on par with resident doctors, says Shashank, an intern. “I am glad that we are being paid but this is not uniform in Mumbai. However, I don’t know why the senior faculty are being given incentives for staying at home and guiding us?” he asks.

Juniors over seniors

As the number of COVID-19 cases has increased and the shortage of healthcare staff intensified, a lot of medical students have been assigned COVID-19 duties.

As the mid-aged group is more prone to the virus, young medicos are expected to perform hardcore clinical duties. In almost all hospitals, juniors are on COVID-19 duties and seniors will be called in only during emergencies.

“Our senior doctors wouldn’t come on rounds. They would be sitting at their homes comfortably and we (junior doctors) literally sacrificed our lives. Very few doctors came (to wards) only when the younger lot started falling sick. They were trying to keep themselves safe and that was shocking,” says a junior doctor in Mumbai’s Jasloka hospital.

However, Shashank says it is only fair that they are looking at their health. “Most of our senior consultants are above 50. With co-morbidities, it is only fair that they are protecting themselves. They, however, helped us through video calls, phone calls etc,” he says.

Traumatic experiences

A few weeks ago, Shashank witnessed something devastating at a hospital in Mumbai. “I was treating a COVID-19 patient who was around 60 and was critical. One day his son requested me to discharge his father as his mother had died two days ago in the same hospital. He had not told his father about his wife’s death. He just crashed in front of me and I stood there helpless,” he says.

A day after this incident, the boy lost his father too. “This is just one incident, at the very beginning of my career. It was devastating. I have to witness such cases on a daily basis,” Shashank says.

To witness and declare deaths when one has just entered the profession is both challenging and traumatizing, says Angeline, a Mumbai based psychiatrist who is on COVID-19 duty. “These interns have never seen deaths, ICUs or even patients who are seriously ill. They get traumatized witnessing 10-20 deaths a day,” says Angeline, adding that some interns don’t even know how to wash surgical instruments.

When these young medicos are asked what keeps them going, despite being underpaid and overworked, they say if not now, when?

Shruti, another junior doctor in Bengaluru says smiles of recovered patients is what keeps her going. “Our patients’ recovery is all we want. That is enough for us and honestly, that is why I am still here.”