Mental Health Challenges Among Doctors in India: A Scoping Review of Existing Research

Abstract

Purpose of the Review:

The mental health of doctors in India is a growing public health concern due to its impact on healthcare delivery, patient outcomes, and professional fulfillment. There is a lack of comprehensive synthesis of the existing literature; hence, this scoping review was conducted. The objective of this review was to map and synthesize the literature on the mental health challenges doctors face in India and to provide a comprehensive overview of key issues.

Collection and Analysis of Data:

A detailed literature search was conducted across PubMed, EBSCO, Web of Science, and Google Scholar databases, covering studies from 2000 to 2024. Data extraction included the sample size, population characteristics, mental health issues investigated, study focus, and key findings. A descriptive synthesis and thematic analysis were performed. This review included 122 studies predominantly conducted across India. More than half of the surveyed doctors exhibited significant levels of depression and anxiety, often linked to long working hours, inadequate rest, and high occupational demands. Lifestyle disorders, including inadequate sleep, poor physical activity, and unhealthy diets, were prevalent and exacerbated stress. Work–life balance was achieved by only 25% of doctors, with gender disparities placing additional burdens on females. Higher emotional intelligence correlated with better professional and life satisfaction. Organizational stressors, including resource shortages and workplace conflicts, contributed to burnout, with rates varying across specialties.

Conclusions:

Indian doctors face mental health challenges due to professional pressures, work–life imbalance, gender disparities, and resilience issues. Systemic interventions are urgently needed, including mental health support systems and emotional intelligence training.

Keywords

Mental health issue psychological health issue doctors medical practitioners India occupational well-being

The health of healthcare professionals has been getting increasing attention worldwide, and a growing body of research examines the mental health challenges doctors face in developing countries.¹ In India, this issue is a pressing concern in the healthcare system. This scoping review synthesizes findings from studies examining various aspects of doctors’ mental health in India. As they play a crucial role in patient care and healthcare delivery, understanding this issue is essential for ensuring the health of both doctors and patients. It is not only a personal concern for doctors but also a significant public health issue that can impact healthcare delivery, patient outcomes, and overall healthcare system efficacy.^2–4 Doctors in India usually work under immense pressure, juggling large patient volumes with limited resources,^5–7 which creates a work environment conducive to mental health challenges.⁸ These challenges are compounded by sociocultural expectations, work–family conflicts, and the stigma associated with seeking mental health support, leading to significant occupational stress and reduced job satisfaction and professional fulfillment.^9–11 In the Indian context, these issues appear to be pronounced due to disparities in healthcare infrastructure across urban and rural regions, varying workloads, and the added societal expectations placed on healthcare professionals.^6,12–14 Global data consistently underscores the increased risk of mental health issues among healthcare professionals compared to the general population.^15,16 However, in India, the situation is worse than in Western countries due to hierarchical work structures, cultural norms that discourage open discussions about mental health, and gender-specific expectations,^17–19 such as balancing professional responsibilities with familial expectations.^20–22 Addressing these mental health issues is an essential need of the hour not only to reduce attrition rates among doctors and improve their overall well-being but also to enhance patient care standards. As doctors are at the forefront of healthcare delivery, their mental health directly influences their decision-making, patient interactions, and overall performance. Poor mental health among doctors can lead to diminished empathy, compromised clinical performance, medical errors, and strained patient–doctor relationships.

There is a lack of comprehensive synthesis of the existing literature on the prevalence, determinants, and impacts of mental health challenges among doctors in India; hence, this scoping review is being conducted. This review aims to map and synthesize the existing literature on the mental health challenges doctors face in India, providing a comprehensive overview of key issues. Findings highlight and prioritize the mental well-being of doctors, thereby fostering a healthier and more resilient healthcare workforce.

Methods

This scoping review followed the methodological framework outlined by Arksey and O’Malley²³ and adhered to the updated recommendations of the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) Extension for Scoping Reviews²⁴ to ensure a comprehensive synthesis of available evidence and an understanding of key themes, gaps, and research priorities in this area (Figure 1).

Figure 1.

PRISMA: Preferred Reporting Items for Systematic reviews and Meta-analyses.

Search Strategy

A comprehensive search strategy was developed to identify peer-reviewed and gray literature related to the subject. Searches were conducted on the electronic databases PubMed/MEDLINE, Scopus, EBSCO, PsycINFO, WOS, and Google Scholar. Gray literature searches included government reports, health organization publications, dissertations, conference proceedings, and preprints.

The search strategy combined Medical Subject Headings terms and keywords related to “mental health,” “psychological health,” “mental illness,” “psychiatric illness,” “doctors,” “physicians,” “surgeon,” “India,” “depression,” “anxiety,” and “suicide.” This review included studies published between 2000 and 2024, ensuring a comprehensive analysis of the trends and developments. The search used Boolean operators (Applied AND/OR operators to combine search terms), truncation, and proximity operators where appropriate. All identified citations were imported into reference management software (Zotero), and duplicates were removed. Two independent reviewers screened the titles and abstracts based on the eligibility criteria. The full-text articles of potentially relevant studies were retrieved and independently assessed for eligibility. Discrepancies were resolved by discussion or by a third reviewer.

Study Selection

Inclusion and exclusion criteria were developed using the Population–Concept–Context framework. The population was all medical doctors, both Indian and foreign-trained, actively engaged in direct or supervised patient care within India and holding a minimum of a Bachelor of Medicine and Bachelor of Surgery degree; the concept was “studies focusing on mental health.” This review does not include “stress and burnout,” as they were submitted elsewhere (because sufficient research was available). The context was “studies conducted in India.” The studies included were original research articles, observational studies (cross-sectional, cohort, and case–control), relevant reports, and conference proceedings with robust data published in English. Studies were excluded if they were focused on a pandemic, case reports, editorials, opinion pieces, or any studies focused solely on healthcare workers who were not doctors (e.g., nurses, allied health professionals), solely on non-modern doctors (Ayurvedic, Unani, etc.), or were conducted outside India.

Data Extraction

A data extraction form was developed to chart data from the included studies. Key information extracted included author(s)/publication year/affiliation, study design/sample size/region/gender, population characteristics, mental health issues investigated, study objective, and key findings. Data extraction was performed by one reviewer and checked by a second for accuracy and consistency. The results were synthesized using a narrative approach, summarizing the findings according to the prevalence and types of mental health issues. The quantitative data were summarized descriptively. Although scoping reviews typically do not assess the quality of the included studies, a brief appraisal was conducted to provide context regarding the study limitations and potential biases.

This scoping review adhered to ethical guidelines by utilizing publicly available data without engaging human participants, negating the need for institutional review board approval. We ensured transparency by providing a transparent, replicable methodology and respected the integrity of the original research through accurate citations. Data management was conducted securely (using Zotero), and systematic procedures were used to minimize bias, involving two reviewers to enhance objectivity. The scope of the review was limited to the available literature on the mental health of doctors in India and may be subject to publication bias. Additionally, variations in mental health assessment tools and study designs across studies could have affected comparability.

Results

Of the 122 studies included (Figure 1), most were centered around tertiary care centers (public and private), covering multiple specialties of doctors, particularly residents and interns, and doctors in primary healthcare settings, general hospitals, and clinics. Various medical specialties were involved in the studies, notably psychiatry (26) and community medicine (24). Among the nonmedical disciplines, the predominant contributions were from management (15) and psychology (19). A considerable number of studies were published between 2020 and 2023. Collaboration between medical and nonmedical disciplines was also noted. All studies were cross-sectional, with sample sizes ranging from 20 to several hundred, and were predominantly conducted in North India (39), followed by South (37), West (29), East (8), and Central India (7). Gender representation varied from balanced to predominantly male or female. Regional variations in study objectives were also noted. Research from North and South India often highlighted work–life balance, burnout, and emotional intelligence (EI). At the same time, studies from West and Central India commonly examined emotional health, lifestyle factors, and stress, often incorporating gender comparisons to understand disparities.

However, across all regions, there was a significant emphasis on exploring workplace stress, burnout, and mental well-being. Across India, more studies have focused on the doctor populations such as residents and interns (Table 1 and Supplementary Table 1). Thematic analysis of the study objectives and key findings revealed several interrelated themes reflecting the complexities of mental well-being in this professional group. The following major themes emerged in this scoping review:

Table 1.

List of Studies Included for the Scoping Review on Mental Health of Doctors in India.

	Author(s)/Publication Year/Affiliation	Study Design/Sample Size	Population Characteristics	Mental Health Issues Investigated	Study Objective	Key Finding
1.	Virmani et al. 2022/Medical/Medicine and Pharmacology²⁵	Cross-sectional/East India/N = 146/male = 80%; females = 20%	Doctors in a metropolitan city	Lifestyle and professional issues	Prevalence of smoking, alcohol abuse, professional satisfaction, and medicolegal issues among respondents	6.25% were current smokers, 3.47% had regular alcohol intake, 45.83% were teetotalers, 41.87% were social drinkers, 20.98% had faced a medicolegal problem, 61.43% had emotional stress, 92.14% were satisfied with their profession and 75% with their income, and 73.38% admitted committing an error in choosing a career.
2.	Veeresh et al. 2011/Medical/Dentistry²⁶	Cross-sectional/South India/N = 230/male = 59%; female = 41%	Consultant/faculty doctors of Ayurvedic, allopathic, and dental colleges	Lifestyle	To evaluate the lifestyle of Ayurvedic, medical, and dental doctors at tertiary care centers	Medical and dental doctors had lower physical activity (due to insufficient time) and higher mental stress than Ayurvedic doctors.
3.	Vashisht and Vashisht, 2022/Non-medical/Management²⁷	Cross-sectional/North India/N = 670/males = 58.5%; females = 41.5%	Doctor of public and private hospitals	Career calling and organizational citizenship behavior	Relationship between doctors’ career choices and their behavior toward organizational citizenship	Career calling had a positive impact on work–life balance and job satisfaction, which in turn reduced occupational burnout.
4.	Ukey et al. 2020/Medical/Medicine²⁸	Cross-sectional/Central India/N = 100/male = 56% Female=44%	Resident doctors of a public tertiary care center	Emotional intelligence	To assess emotional intelligence among postgraduate medical students	58% had a satisfactory score, and males had significantly better emotional awareness and management than females. Top of Form Bottom of Form
5.	Swami et al. 2013/Medical/Psychiatry²⁹	Cross-sectional/West India/N = 56	Resident doctors of a tertiary care center	Emotional intelligence, perceived stress burnout	The relationship of burnout, emotional intelligence, and perceived stress among resident doctors	Emotional intelligence negatively correlated with burnout and perceived stress, while perceived stress and burnout were positively correlated.
6.	Solanki et al. 2015/Medical/Psychiatry³⁰	Cross-sectional/West India/N = 200/male = 50%; female = 50%	Doctors of a tertiary care center	Work stressors and psychiatric morbidity	To compare the gender differences in work stressors and psychiatric morbidity among doctors and nurses	Though both female doctors and nurses scored higher than their male counterparts, there were no differences in terms of gender or occupation. A similar observation stands for psychiatric morbidity. Males reported a lack of staff/resources as a significant stressor, while females cited disputes with staff/seniors. Depression, stress, and anxiety were self-rated at 9.45%, 20.2%, and 29.2%, respectively, with no significant gender differences in psychiatric morbidity.
7.	Singh et al. 2021/Medical/Community Medicine³¹	Cross-sectional/North India/N = 100/male = 50%; female = 50%	Resident doctors of a tertiary care center	Satisfaction and well-being	Assess student and resident doctor satisfaction and well-being	Most residents (68%) were satisfied with their lives, influenced by valued profession, institution reputation, and income.
8.	Sasidharan et al. 2016/Medical/Pharmacology⁸	Cross-sectional/South India/N = 114/ Male = 63%; Female = 37%	Intern and resident doctors of a private tertiary care center	Depression	Investigate depression, stress, anxiety, and associated substance abuse among junior doctors	Prevalence of depression was 11.40%, anxiety 40.35%, and stress 9.65%. Sixty percent of males used alcohol, and 54% of females used benzodiazepines. Night calls and long work hours caused stress, depression, and anxiety.
9.	Shankar and Ramya, 2017/Medical/General Medicine³²	Cross-sectional/South India/N = 100/male = 65%; female = 35%	Doctors of a tertiary care center	Lifestyle	Examine the personal habits and lifestyle of healthcare professionals	Healthcare physicians had poor physical activity, diet, and sleep habits—few practiced yoga. Overweight and obesity were common.
10.	Roy et al. 2022/Medical/Psychiatry³³	Cross-sectional/East India /N = 170/male = 67%; female = 33%	Resident doctors of a public tertiary care center	Psychiatric morbidity and burnout	Investigate burnout and psychological issues in postgraduate resident doctors	30% experienced burnout, and about 17% experienced psychiatric illness. Common burnout domains were depersonalization (35%) and emotional exhaustion (31.7%). Common morbidities were tobacco use, depression, and anxiety (4%). High burnout was noted in the Department of Anesthesiology, followed by Pulmonary Medicine and Radiotherapy.
11.	Kulkarni et al. 2013/Medical/Psychiatry³⁴	Cross-sectional/North India/N = 75/male = 64%; female = 36%	Doctors of a public tertiary care center	Psychological well-being, satisfaction with life	The impact of age, sex, marital status, and experience on psychological well-being and life satisfaction among doctors at a tertiary care hospital	Age and practice experience influence vitality, while marital status affects overall well-being and life satisfaction. Anxiety, positive well-being, and self-control impact satisfaction. Married doctors have better well-being than singles, and those with reasonable emotional control are more satisfied.
12.	Pandey and Singh, 2019/Nonmedical/Psychology³⁵	Cross-sectional/West India/N = 160/male = 50%; female = 50%	Doctors of private and public tertiary care center	Emotional intelligence	To compare the emotional intelligence of doctors in private and public hospitals	There were differences in emotional intelligence between doctors in private and public hospitals. Male doctors had higher emotional intelligence overall, especially in expressing and managing emotions. Female doctors in private hospitals had higher emotional intelligence in utilizing emotions. There were significant interactions between gender and hospital type for most emotional intelligence factors, but no significant interactions with total emotional intelligence.
13.	Nair et al. 2017/ Medical/Ophthalmology¹⁹	Cross-sectional/West India/N = 297/male = 34%; female = 66%	Ophthalmologist across India	Work satisfaction, burnout, and inequalities	Work satisfaction, burnout, and gender-based inequalities among ophthalmologists in India	54.21% were satisfied with their jobs, and 25.2% had burnout. 68.35% opined that this job is challenging for women due to family responsibilities, long working hours, and having to work harder. Significant gender disparity was opined with regard to earnings.
14.	Madhavi, 2016/Nonmedical³⁶	Cross-sectional/South India/N = 320/male = 50%; female = 50%	Doctors of a multiple public and private tertiary care centers	Work–life balance	To evaluate work–life balance factors and their influence	Only 25% of medical professionals have a good work–life balance due to long hours, lack of family time, knowledge updates, and focus on patient feedback. 51% of doctors work over 10 hours daily, 63% lack sleep, and work fatigue leads to stress and depression. Those focusing on knowledge updates have better work–life balance.
15.	Kumari and Raghuramapatruni, 2023/Non-medical/Management²⁰	Cross-sectional/South India/N = 100/female = 100%	Doctors of tertiary care, general hospitals, and clinics	Work–life balance, job satisfaction	To investigate work–life balance and job satisfaction among female doctors	25% had poor personal satisfaction, 50% were dissatisfied with family life, and 65% had inadequate family support. Night shifts and gender discrimination are challenging. Job satisfaction is low among women doctors, with work–life balance significantly impacting it.
16.	Khateeb, 2023/Non-medical/Management³⁷	Cross-sectional/North India/ N = 364/female = 49%; male = 51%	Doctors from the public tertiary care center	Work–family interface	The study explores the relationship between work and family life among doctors	WTFE enhances job and life satisfaction, while FTWE only improves life satisfaction. Self-efficacy significantly influences both, indirectly influencing WTFE but not FTWE.
17	Khan S, (2024)/ Medical / Pathology³⁸	Cross-sectional/ North India/N =450/female = 58%; male = 42%	Pathology resident and consultant in North India	Burnout	Health risks among pathologists in North India	42% had depression and burnout
18.	Kaur et al. 2009/Medical/Community Medicine³⁹	Cross-sectional/North India/N = 250/female = 34%; male = 66%	Resident and Intern doctors from multiple public and private tertiary care centers	Job satisfaction, work environment	Job satisfaction and its attributes among doctors in a tertiary hospital	50% of the doctors were dissatisfied with their working hours, especially those with long night shifts. 45% were unsatisfied with the salary, and 55% with the choice of profession.
19.	Grover et al. 2018/Medical/Psychiatry¹⁰	Cross-sectional/North India/N = 445/male = 69%; female = 31%	Residents and consultant doctors from multiple public and private tertiary care centers	Burnout, psychological issues	To explore the psychological issues and burnout among medical professionals in tertiary care settings	30.1% had depression, and 16.7% had suicidal ideations. More than 90% reported some level of burnout, residents more than faculty. Stress, depression, and burnout have a positive link to lack of recreational activities, negative experiences with seniors, and abuse from patient caregivers.
20.	Garg et al. 2022/Medical/OBG and others⁴⁰	Cross-sectional/Pan India/N = 377/male = 55%; female = 45%	Doctors from multiple public and private hospitals and clinics across India	Lifestyle disorders	To investigate the link between lifestyle disorders and behaviors among doctors	48% had inadequate sleep, 45% consumed alcohol, 14.1% had diabetes, and 23.1% suffered from varying degrees of hypertension. Surgeons had more diabetes and hypertension than physicians, especially self-employed males.
21.	Bhattacherjee et al. 2016/Medical/Community Medicine⁴¹	Cross-sectional/East India/N = 255/male = 73%; female = 27%	Residents and consultant doctors of a public tertiary care center	Job satisfaction	To assess job satisfaction and associated factors among doctors in a tertiary care hospital in eastern India	59.6% had job satisfaction commonly among older age, male gender, preclinical/paraclinical roles, and longer tenure. Dissatisfaction was associated with interpersonal relations, human resources, environment, and patient relationships.

FTFE: Family-to-work enrichment, WTFE: Work-to-family enrichment.

Emotional Well-being and Intelligence

More than half (58%) of postgraduate medical students had satisfactory EI scores, with men outperforming women in emotional awareness.²⁸ Higher EI positively correlated with well-being and life satisfaction.⁴² Similarly, more than half (53%) and nearly half (45%) of resident doctors reported experiencing depression and anxiety⁴³; however, perceived stress and burnout were inversely related to EI²⁹ (Table 1).

Lifestyle and Health Behaviors

Lifestyle disorders have been reported, including inadequate sleep, high rates of alcohol consumption,⁴⁰ poor physical activity levels, unhealthy diets, and inadequate sleep.³² Lower physical activity levels among modern medical and dental doctors were observed compared with their Ayurvedic counterparts, which was linked to insufficient time and elevated mental stress²⁶ (Table 1).

Work–life Integration and Family Dynamics

Approximately 25% of doctors achieved a good work–life balance, with major determinant factors being long working hours, inadequate family time, and pressure to update professional knowledge.³⁶ Work-to-family enrichment enhanced job and life satisfaction, whereas family-to-work enrichment primarily impacted life satisfaction³⁷; however, doctors with a strong career calling experienced better work–life balance and reduced burnout²⁷ (Table 1).

Organizational and Workplace Influences

Workplace stressors such as lack of staff or resources and disputes with colleagues were significant stressors, leading to psychiatric morbidity in some cases.³⁰ Workplace dissatisfaction often stems from human resource issues, interpersonal relationships, and patient interactions,⁴¹ but career calling could positively influence work-related outcomes²⁷ (Table 1).

Occupational Stress and Burnout

A study revealed that up to 61.43% of doctors may experience emotional stress, with 20.98% reporting medicolegal issues as a significant stressor.²⁵ Among the residents, 30% faced burnout, predominantly in the departments of anesthesiology and Pulmonary Medicine.³³ High levels of stress and anxiety have also been linked to workplace factors such as long working hours, insufficient rest, and intensive care demands. Among pathologists, the burnout rate was 42%,³⁸ while among ophthalmologists, it was 25.2%, particularly among women¹⁹ (Table 1).

Demographic and Sociocultural Influences

Sociocultural factors such as gender, marital status, and regional variations affect doctors’ mental health. Married doctors had better well-being than their single counterparts,³⁴ and significant gender disparities were also noted.¹⁹ Moreover, regional differences were observed, with physicians from different specialties and areas displaying variations in lifestyle-related disorders⁴⁰ (Table 1).

Discussion

This scoping review of studies on the mental health of doctors in India reveals various challenges, including occupational stress, emotional disturbances, lifestyle issues, work–life integration, and organizational influences. Female doctors face unique challenges, while structural issues within healthcare organizations exacerbate stress across all demographics.

Fatigue and distress among Indian doctors remain significant issues and align with global findings,^44–46 predominantly linked to emotional stress, professional dissatisfaction, and medicolegal challenges.^25,33 International studies also identify similar stressors, such as high workloads, limited support systems, and inadequate resources, emphasizing that these challenges are systemic and not unique to India.^47–49 However, Indian doctors might be at the receiving end. For example, the POSEIDON study, conducted on February 1, 2011 (a single day), reported that 204,912 patients visited 7,718 primary healthcare practitioners in India from 880 cities and towns, reflecting the massive workload of doctors in India.⁵⁰ In the private sector, the workload of doctors can be overwhelming, with some seeing more than 200 patients per day.⁵¹ Resident doctors work 50–100 h/week.^10,52 Additionally, doctors in public settings are often required to handle administrative jobs related to rigor in implementing various policies.¹⁸ In addition, many factors augment the prevalence of these challenges.⁴⁵ Jeffery highlights several challenges faced by doctors in India, including a decline in public image, increasing aggression and violence, difficulties in occupational closure (such as political support for alternative medical systems, the rise of subordinate medical personnel to independent practice, and social controls over access to medical colleges), fractures in social cohesion, corporatization, day-to-day corruption, and malpractice.⁵³

Gender disparities highlighted in previous studies provide critical insights into the specific challenges faced by female doctors, including balancing family responsibilities, managing long working hours, and coping with societal expectations.¹⁹ Such findings resonate with global data showing that women in healthcare often face a “double burden” of professional and domestic responsibilities, contributing to increased rates of burnout and stress compared with their male counterparts.^54,55 In general, women’s struggles begin at the start of their medical careers and when, as a gender, they are predisposed to experience disproportionately more stress and burnout than men,⁵⁶ a trend that continues into residency.⁵⁷ Many prioritize career advancement by delaying starting a family, as motherhood slows career progression.⁵⁴ In developing countries, major issues include time constraints, patriarchal proclivities, and task-pay disparities.⁵⁸ There must be an explicit policy at the institutional and national levels, and legislative reform must address these issues.

The relationship between EI and mental health was a recurring theme in the reviewed studies. Higher EI scores, as reported by Ukey et al. and Sharma et al. are associated with improved emotional regulation, greater resilience, and better overall well-being.^28,59 This finding supports theoretical models that emphasize the protective role of EI against occupational stress.⁶⁰ Conversely, Swami et al. demonstrated that lower EI scores are correlated with higher perceived stress and burnout.²⁹ This suggests that targeted interventions to improve EI among doctors could positively reduce stress and enhance job satisfaction.^61,62 It is to be noted that EI is an important component of medical practice, though not officially mandated. It positively correlates with patient trust in doctors and plays an important role in doctor–patient relationships.⁶³ EI metrics correspond to numerous qualities that contemporary medical courses aim to impart. Elevated EI enhances and fosters empathy, improves teamwork and communication skills, and facilitates stress management, organizational commitment, and leadership.⁶⁴ EI benefits all levels of physicians and enhances their ability to handle psychological effects in the healthcare field. Training can improve EI and predict and enhance the success of doctors, residents, and medical students.⁶⁵ It should also be noted that this is not highlighted during training and is closely linked to resilience in the Indian context.⁶⁶ There is an urgent need to incorporate EI into the medical curriculum to prepare students to face potential challenges in their medical careers.

Lifestyle factors, such as poor physical activity, unhealthy diets, and inadequate sleep, further exacerbate stress and mental health challenges. Studies by Shankar and Ramya and Garg et al. found that many doctors struggle to maintain healthy lifestyles due to demanding work schedules, limited leisure time, and the pressure to remain professionally competent.^32,40 Such findings highlight the need for systemic changes to promote healthier work environments, including initiatives supporting physical health and improving work–life balance. Similar observations have been made in other countries, though with less magnitude, including insufficient physical activity, excess weight, insufficient sleep, risky drinking, and smoking.^67,68 It is to be noted that there appears to be a rise in mortality among Indian doctors at an early age,⁶⁹ and the majority of attributable factors are linked to lifestyle.¹⁴ Literature suggests mentorship-based, mindfulness-based interventions to reduce the mental well-being of physicians.^70,71 However, doctors also encounter barriers to practicing a healthy lifestyle.^72–74 On other hand, physicians who maintain a healthy lifestyle are more likely to recommend similar practices to patients, thereby contributing to noncommunicable disease prevention.^75,76

Theoretical Implications

The interplay between EI, occupational stress, and lifestyle behaviors supports the models of resilience and emotional regulation. These models are widely used to understand and promote adaptive functioning and stress coping in individuals; some of these models include the Resilience Framework,⁷⁷ Gross’s Model of Emotion Regulation,⁷⁸ The Five Pillars of Resilience Model,⁷⁹ Transactional Model of Stress and Coping⁸⁰ (by Lazarus and Folkman), and Self-Compassion Model⁸¹ (by Kristin Neff). For medical professionals, due to diverse factors, an inclusive approach that should include an emotion regulation and resilience framework⁸² delivered via mindfulness and stress reduction training have shown effectiveness in reducing anxiety and improving emotional regulation, cognitive-behavioral approaches (cognitive reframing techniques to manage negative thoughts and emotions), peer support and mentoring programs (building resilience by fostering social support and reducing isolation), and organizational changes (creating policies and structures that reduce stressors, promote work–life balance, and provide resources for well-being).⁸³ Systemic changes, such as workload management, flexible scheduling, peer support groups, and institutional wellness programs, are crucial to alleviating stress and enhancing job satisfaction. Virmani et al. and Bhattacherjee et al. underscore the importance of policy-level reforms in creating supportive work environments and mitigating the impact of medicolegal challenges and resource constraints.^25,41 Additionally, gender-sensitive policies that address the unique challenges faced by female doctors could improve their professional experience and reduce disparities in mental health outcomes.

This review highlighted an overview of mental health issues faced by doctors in India; however, there appear to be several gaps. There is a paucity of longitudinal studies that track mental health issues over time to understand the etiological factors and efficacy of interventions. More studies are needed to explore the specific needs of female doctors, so it is necessary to explore the differential stress and burnout experiences across various medical specialties to yield more tailored interventions. For example, high burnout rates reported among anesthesiologists and oncology residents suggest that these groups may require targeted support.³³ In addition, examination of the cultural impact on mental health outcomes, as cultural expectations around stoicism and resilience, may lead to underreporting of mental health issues. Hence, interventions should be culturally sensitive and tailored to the unique social dynamics of the Indian healthcare system.

Overall, the synthesis of data across multiple themes revealed a complex interplay between individual, organizational, and sociocultural factors in determining the mental health outcomes of doctors. At the individual level, EI and coping strategies are crucial for resilience, but the influences of the organization and system are equally important. Studies by Solanki et al. (2015) and Bhattacherjee et al. reported that workplace stressors such as inadequate staffing, long hours, and disputes with colleagues significantly impact doctors’ mental health.^30,41 Thus, there is a need for a holistic approach that addresses both individual and systemic factors to foster well-being and job satisfaction. However, we should not deny that many doctors also report high levels of job satisfaction and fulfillment, particularly among those who find meaning and purpose in their work, such as those with strong career calling.^25,27 This suggests that interventions should reduce adverse outcomes and enhance the factors contributing to positive professional experiences.

Limitations

The review’s reliance on cross-sectional studies limits causal inferences, and potential biases exist, including publication bias and under-reporting of sensitive issues. India’s unique sociocultural context necessitates caution when comparing our findings to international data. Although not our primary focus, burnout studies were included when they were explored in relation to mental health factors such as job satisfaction. This overlap provides a valuable context, reflecting the interconnected nature of physician well-being. However, this shifted our intended focus slightly and potentially overshadowed other nuanced mental health aspects.

Conclusion

While our initial aim was to map and synthesize the literature on mental health challenges among doctors in India, our findings revealed a broader yet equally critical narrative. High levels of occupational stress, burnout, emotional disturbances, and lifestyle-related health issues have emerged as pervasive concerns. These issues were so prominent that they could not be overlooked, highlighting their profound impact on the mental health and well-being of doctors in India. Systemic factors such as long working hours, inadequate organizational support, and gender disparities exacerbate these challenges. Interestingly, EI surfaced as a key factor influencing resilience and job satisfaction, whereas poor lifestyle habits compounded the overall burden on doctors’ well-being. Our findings call for a multifaceted approach to address these challenges, including fostering EI, creating healthier work environments, and implementing policy-level interventions to promote work–life balance and reduce systemic stressors. While our review is limited by its reliance on cross-sectional studies and potential reporting biases, it underscores the urgent need for systemic reforms to safeguard doctors’ well-being, a critical step toward improving their health and the quality of patient care they deliver. Future research should explore the longitudinal impacts, gender-specific needs, and targeted interventions across specialties to build on these insights.

Supplemental Material

Supplemental material for this article is available online.

Supplemental Material

Supplemental material for this article is available online.

Footnotes

Acknowledgements

The authors thank Yahosha, Shamaya, Hagai, Asther, Yasuas, Marias (Divine Retreat Centre, Chalakudy, Kerala, India), Ashish, and Mini for their support.

Declaration of Conflicting Interests

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Declaration Regarding the Use of Generative AI

None used.

Ethical Approval and Informed Consent

As this was a synthesis of data available in the literature, no patient consent or ethics committee approval was sought.

Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

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