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\begin{document}

             \author[1]{Dr. Saranya  Nagalingam}

             \author[2]{Annamalai  Sowmiya}

             \author[3]{Dr. Balaji  Arumugam}

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\date{\small \em Received: 16 December 2018 Accepted: 5 January 2019 Published: 15 January 2019}

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\begin{abstract}
        


For many years now, there has been an increased suicidal rate among medical professionals compared to the other professions. The suicides are mainly due to stress, anxiety and depression among medical professionals. A Study conducted by Dr. Balaji Arumugam et al suggested that 9.4% of participants working in Medical profession were stressed due to their occupation.(1) Despite the high prevalence of stress in doctors, and a myriad of physical and mental health consequences, doctors are notoriously reluctant to seek help for themselves.(2) Let us discuss in detail about stress factors, views about stress among medical professionals, preventive measures to control stress among medical professionals.

\end{abstract}


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\let\tabcellsep& 	 	 		 
\section[{Introduction}]{Introduction}\par
or many years now, there has been an increased suicidal rate among medical professionals compared to the other professions. The suicides are mainly due to stress, anxiety and depression among medical professionals. A Study conducted by Dr. Balaji Arumugam et al suggested that 9.4\% of participants working in Medical profession were stressed due to their occupation. \hyperref[b0]{(1)} Despite the high prevalence of stress in doctors, and a myriad of physical and mental health consequences, doctors are notoriously reluctant to seek help for themselves. \hyperref[b1]{(2)} Let us discuss in detail about stress factors, views about stress among medical professionals, preventive measures to control stress among medical professionals. 
\section[{II.}]{II.} 
\section[{What is Stress?}]{What is Stress?}\par
Stress is defined as undue, inappropriate, exaggerated response to a situation. Seyle in defined stress as "the non-specific responses of the body to any demand for change". This stress could either be "Eustress" or "Distress". Eustress is a positive stress which pushes a person to do his best in his work. Challenges are exciting and motivates to plan an exit strategy. But, in the other way, "Distress" prevents the person to do his work properly and makes his anxious and depressed. Threats to elicits a greater stress response from an individual. Distress is more prevalent among medical professionals. 
\section[{III.}]{III.} 
\section[{Stressors}]{Stressors}\par
As compared to other professionals, medicos are exposed to more stressors in their professional domain. Several stress factors are as follows: IV. 
\section[{Effects of Stress}]{Effects of Stress}\par
Due to these stressors, the medicos feel depressed and anxious. The long term, experiences doctor ends in a "burn out phenomenon" termed by Felton. This is quite common with the doctors who are having high levels of stress for longer time.\par
Burn out Phenomenon is a triad of emotional exhaustion, depersonalization and lack of selfaccomplishment. Emotional illnesses can lead to anxiety disorders, addictions, depression, eating disorders, and suicide \hyperref[b2]{(3,}\hyperref[b3]{4)} 'Emotional exhaustion' is that the person become non sensitive and they don't react emotionally to any situations. 'Depersonalization' is the one in which the doctor visualizes the patient as just a piece of disease, not realizing that they were humans. This would probably change the doctor's attitude towards patients and there would be less productivity. 'Lack of selfaccomplishment' also occurs and it mainly associated with cynicism and the doctors were not ready to believe anyone or even their friends too.\par
There may be onset or increase in the usage of tobacco smoking or alcohol abuse. In order to control their stress, the physicians habituate to take some drugs, which lead to drug addiction.\par
Depression followed by stress will lead to low productivity or low performance in their work. There may increase in clinic hours in late nights without any productivity.\par
Prevalence of Morbidity and Mortality pattern increases in Doctors either like Myocardial Infarction in young generation due to stress or by suicides.\par
V. 
\section[{Doctor's Views about Stress}]{Doctor's Views about Stress}\par
Dr. Sumit Goyal, who is an associate professor in university of Delhi, says, "Stress is very common among medical professionals. The state of Indian medicos now is really pathetic".\par
Dr. M. C. Gupta, who is a Medico legal Expert says," Medical professionals mainly become distressed because of their salary. If 10 years experienced medical professional gets Rs. 20000 as a salary, it would be really distressing." -Here the Experience is neglected. 
\section[{VI.}]{VI.} 
\section[{Prevention of Stress}]{Prevention of Stress}\par
Preventive measures to control stress should stay as early as the initial period curriculum. Some of the preventive measures are as follows:\par
? Adequate holidays: Adequate holidays should be given to doctors. They must be given the privilege of enjoying occasions with their family by increasing the number of doctors in each institution. Rotational duties with adequate holidays would encourage better health care system. ? Good Salary: Doctors are deserved to pay higher so that they need not have to toil hard for better salary for their family situations. They are not exempted from electricity bills, GST, Taxes etc, but the community expects service from them. Quality of Care can be assured for the patients.\par
? Recent Advancements: Can be invested in hospitals to make working place more comfortable the doctors should be skilled to use those instruments.  
\section[{Conclusion}]{Conclusion}\par
Being a medico, perception of stress may vary from an individual to another but they are trained to perform well in a "Very stressful environment by Adopting coping strategies". All doctors possess Stress as an inseparable companion. Control of stress is much more important than their performance in their fields. When doctors ensure to balance their professional and personal life with a positive attitude then they can never be embraced with pessimism.  \begin{figure}[htbp]
\noindent\textbf{} \par 
\begin{longtable}{P{0.17826231691078562\textwidth}P{0.6717376830892143\textwidth}}
\tabcellsep a patient. Lack of recent advancements in a rural\\
\tabcellsep area would be very pathetic.\\
\tabcellsep ? Harder subjects: "Doctors" -The Journey to begin in\\
\tabcellsep this profession is strenuous. Medical students have\\
\tabcellsep to spend at least 6-8 hours daily for reading, in\\
\tabcellsep order to pass their subjects. On the other hand, for\\
\tabcellsep entering into prestigious institutes for postgraduate\\
\tabcellsep course, they have to study for at least 16-18 hours\\
\tabcellsep per day.\\
\tabcellsep ? Expectation from society: ? Fear of future: After completing MBBS, the medical\\
\tabcellsep graduates undergoes a miserable life that their\\
\tabcellsep Cherished dreams of becoming a doctor shatters\\
\tabcellsep after they understand the reality. Most of the\\
\tabcellsep graduates are undergoing tremendous stress and\\
\tabcellsep this has increased the prevalence of Suicides and\\
\tabcellsep suicidal tendency in this Profession.\\
\tabcellsep ? Lack of training: In developing countries like India,\\
\tabcellsep there is a lack of skillful training to the students even\\
? Long working hours: Doctors -Decision Makers in life or death situations has to work more than 48 hours and are subjected to unrivaled physical and pscychological stressors ? Hostile environment: Working place in some hospitals would be quite distressing and the doctors were not able to concentrate on disease of\tabcellsep in more prestigious institutes. ? Physical Violence: An Alarming issue in the community, people have started harassing doctors without a proper reason. They blindly use aggressive violence against doctors without knowing the importance of the life saving procedure especially during situations like Cardiopulmonary Resuscitations.\end{longtable} \par
  {\small\itshape [Note: ? Social isolation: "It's impossible for a successful doctor to satisfy Professional and Personal Life simultaneously." Being a Medico -who engages his life studying for years together (almost throughout the Life time), could not concentrate on social relationships. They could not attend parties, nominal family occasions and they feel like socially isolated from world. ? Continuous Working days: Since there are decreased numbers of doctors in government hospitals, they wouldn't get leave and they would be working for almost a year continuously. This is one of the most distressing factor.]} 
\caption{\label{tab_0}}\end{figure}
 \begin{figure}[htbp]
\noindent\textbf{} \par 
\begin{longtable}{P{0.85\textwidth}}
? Meditation: Twice daily, meditation can be practiced\\
to relax the mind. Meditation doesn't require special\\
arrangements. It can be done in a working\\
environment.\\
? Counseling: Psychotherapy can be given to a\\
doctor who is suffering from stress and depression.\\
VII.\end{longtable} \par
 
\caption{\label{tab_1}?}\end{figure}
 			\footnote{( )K © 2019 Global Journals} 		 		\backmatter  			  				\begin{bibitemlist}{1}
\bibitem[Adshead (2005)]{b1}\label{b1} 	 		‘Healing ourselves: ethical issues in the care of sick doctors’.  		 			G Adshead 		.  	 	 		\textit{Adv Psychiatr Treat}  		2005 Sep. 11  (5)  p. .  	 
\bibitem[Cromie ()]{b3}\label{b3} 	 		‘Suicide high among female doctors’.  		 			W Cromie 		.  	 	 		\textit{Stress in Medical Profession}  		2005.  	 	 (The Harvard Gazette) 
\bibitem[Myers (ed.) ()]{b2}\label{b2} 	 		\textit{The handbook of physician health},  		 			M Myers 		.  		Goldman L S, Dickstein L (ed.)  		2000. Chicago (IL: AMA Press. p. .  	 	 (Depression and anxiety) 
\bibitem[Arumugam et al.]{b0}\label{b0} 	 		‘Work related stress -A major occupational health issue’.  		 			Balaji Arumugam 		,  		 			Aravind Prasad 		,  		 			Saranya Nagalingam 		.  	 	 		\textit{International Journal of Current Research}  		7  (6)  p. .  	 
\end{bibitemlist}
 			 		 	 
\end{document}
