Stress and Physical Exertion Among Medical Interns During Compulsory Rotatory Medical Internship in India: A Quantitative Assessment

Abstract

Medical interns in India undergo a 12-month Compulsory Rotatory Medical Internship (CRMI) to obtain their medical degree. This period is characterized by heavy clinical duties, long work hours, and frequent on-call shifts, all of which contribute to high stress and physical exertion. This study quantitatively assesses stress levels and perceived physical workload among CRMI interns across three tertiary hospitals in Delhi and Kerala using validated psychometric and exertion scales. A cross-sectional survey of 487 interns was conducted between July and September 2024. Stress was measured with the Perceived Stress Scale-10 (PSS-10) and physical exertion with the Borg Rating of Perceived Exertion (RPE) Scale. The mean PSS-10 score was 21.3 (±5.2), indicating moderate to high stress, with 72% scoring ≥20. The mean Borg RPE was 13.7 (±2.1), reflecting “somewhat hard” physical workload. Female gender, sleep of less than 6 hours per night, and on-call frequency greater than 8 shifts per month were independently associated with higher stress (p < 0.01) and exertion (p < 0.05). These findings underscore the urgent need for institutional policies to mitigate CRMI interns’ mental and physical burden.