Parents, people and you

Duty rosters are hard enough. Then the phone rings at 11 pm and it's home, asking when you're getting married, why you sound tired, or whether the fees instalment went through.

You're not imagining that this adds up. The NMC's own task force wrote that medical students "bear the expectations of their families", and that PG students, "particularly women", struggle with "balancing societal expectations of marriage against professional ambitions, often leading to severe personal conflicts". It also lists "disappointing parents" as a risk factor for distress.

So this section is about the people around you: parents, partners, friends, relatives and the voice in your head that sounds like all of them.

One plain note before we start. This is for everyday coping. It is not a replacement for professional help. If things feel heavier than a bad week, go to the "When it's time to talk to someone" block. Tele-MANAS is 14416 (free, 24x7).

You tell your mother you did three nights in a row. She says, "Don't worry, everything will be fine. Work hard, it's only three years." 🥲

That can land like a door closing. But it usually isn't dismissal. A lot of parents have no picture of what residency is. They know "doctor" as a finished product, not as 36 hours on call with a thesis due. The NMC report itself recommends parent-faculty meetings so families can understand "the academic and clinical demands" and support you better. If the regulator thinks parents need briefing, it's fair that yours don't get it yet.

"Work harder" is often the only advice they have. It's what got them, and you, this far. "Don't worry" is often their own worry, said in reverse.

None of that makes it helpful. You're allowed to feel unheard. You could try one thing: instead of describing how you feel, describe one concrete day. "I came in at 8 am Monday and left at 2 pm Tuesday" gives them something to picture. Feelings are easier to hear once the facts are in the room.

There's rarely a perfect moment, so pick a decent one: not right after a fight, not while they're rushing out, and not from the ward corridor on a post-night.

Some things that make it easier:

• Pick one parent first if one of them usually listens better.
• Start with facts, then the feeling. Hours, sleep, what's changed.
• Say what you need from them. Most parents default to fixing or advising. If you only want them to listen, say so upfront.
• Name what you're not asking for. "I'm not quitting, I'm not failing, I'm telling you because I don't want to hide it."
• Expect a clumsy first reaction. Shock, "what will people say", or instant advice is common. That first reaction is often not their final one. You can come back to it in a day or two.

You don't have to tell them everything. Telling them something is already a step. The next card has a script you can borrow.

Change the words so it sounds like you. Use whatever language you talk to them in.

On a call: "Mumma/Papa, I want to tell you something, and I need you to listen for two minutes before you say anything. Residency is much harder than I expected. I'm working [X] hours some weeks and not sleeping properly. For the last few weeks I've been feeling low most days, and I'm not enjoying things I used to. I'm not in trouble and I'm not leaving the course. I'm telling you because I don't want to pretend with you. I don't need a solution right now. I need you to know, and maybe check on me a bit more."

If a call feels too hard, a text: "Can I tell you something without you getting worried? Things at work are really heavy and I've been feeling low for a while. I'm handling duty, but I'm not okay inside. I'm planning to talk to someone about it. I wanted you to know. We can talk on the phone this weekend."

If they respond with "just pray" or "just work harder", you could say: "I hear you. Right now I only need you to know. Can we leave advice for later?"

Respecting your parents and carrying their expectations as your whole identity are two different things. You can do the first without the second.

Things that tend to help:

• Sharing a rough duty pattern so they know when you can't pick up.
• A short fixed call time, like Sunday evening, instead of guilt about missed calls all week.
• Thanking them for real things they did. That's respect, and it's true.
• Telling them early when something big changes, like leave, a branch doubt or a health issue.

Things that tend to backfire:

• Hiding everything until it explodes.
• Proving yourself in every call by listing marks, cases and praise.
• Letting "what will Sharma uncle's son think" decide your leave, your branch or your marriage.
• Agreeing to everything on the phone and resenting it for weeks.

And the other way round, what's fair to ask of them:

• Not comparing you with cousins or batchmates.
• Not treating tiredness as ingratitude.
• Taking "I'm not okay" seriously the first time.

You can love them fully and still decide your own life. Both can be true.

A lot of us got into medicine partly because of family. Sometimes that was a gift. Sometimes it was pressure that never stopped. Either way, by residency it can feel like your rank, your branch and your degree are the family's project, and you're only the one doing the work.

Adam Kay, a former UK obstetrics registrar, has written about family pressure pushing him into medicine. Years later, after a traumatic case at work, he left clinical medicine and became a writer. One thing he said: "It's vital for people to know that you're human." (Leaving isn't the point here. The point is he's a whole person with a life outside the degree.)

Your parents' hopes are real, and their sacrifice may be real too. But you are the one who has to live in this body, this unit and this life. It's fair to ask yourself: which of my goals are mine, which are theirs, and which do we share?

You don't have to answer that today. You could write down three things you want from the next five years that have nothing to do with a rank. That list is also you.

"You can study after marriage." "Your cousin's younger than you and already settled." "Just meet him once." Familiar? 🫠

The NMC report names this directly: for PG students, "particularly women", there's a struggle "balancing societal expectations of marriage against professional ambitions, often leading to severe personal conflicts". So if this is eating your headspace in the middle of a thesis, that's a known problem, not you being difficult.

Some things residents use:

• A clear timeline you believe in. "After my exit exam" is easier to defend than "later".
• One ally in the family. A sibling, aunt or cousin who can soften things from inside.
• Separating "not now" from "never". Parents often hear refusal as rejection of them.
• Honest limits on meetings. If you agree to meet someone, you can also decide how many, and when.

If you do want to marry during residency, that's valid too. The point is that the timing is yours to weigh. It's your life that will be living with the decision.

Your parents took a loan, broke an FD or sold something so you could study. Now you're a doctor in your late twenties, the stipend doesn't stretch, and you still need money from home. That guilt can sit on your chest every time you open a banking app.

You're far from alone. The NMC report found 72.2% of PG students find their stipend insufficient, 41.6% don't receive it regularly, and 60.1% say money worries affect their well-being. It also recorded that asking family for financial help "induced feelings of guilt, significantly impacting their mental well-being and academic performance". That's the system, not a personal failing.

Dr Yokesh Arul, now a physician, has talked about this openly. His father sold land to pay his private-college fees, and the guilt was heavy. Later, before NEET-PG, self-doubt hit him hard too. What helped was facing the guilt instead of hiding from it, and finding out in a small test that he could do well. It worked out for him, guilt and all.

Guilt usually means you care. It doesn't mean you owe your happiness, health or sleep as repayment. If money is keeping you awake, it may help to talk to your parents about it plainly, as two adults on the same side.

Relatives, neighbours, the family WhatsApp group, the batchmate who posts every achievement. Log kya kahenge gets into everything: whether you take leave, whether you see a counsellor, whether you change branch, whether you say you're struggling.

Here's the uncomfortable thing. Most of those people are thinking about their own lives much more than about yours. The ones who talk will talk regardless of what you do. And the ones who matter mostly want you well.

This matters most around help-seeking. A lot of us skip the counselling cell or a psychiatrist because we worry it'll get around. If that's your worry, Tele-MANAS (14416) is free, 24x7, and not linked to your college. The NMC task force has also recommended confidential counselling with "a firewall" between counsellors and college faculty. Check whether your college has put that in place.

You could try asking yourself one question when this voice starts: "If nobody would ever know, what would I do?" That answer is usually closer to what you actually need.

New city, new language at the OPD counter, food that isn't quite right, and a hostel room that doesn't feel like yours. Homesickness in residency is rarely talked about because you're "an adult now". It's real anyway.

The NMC task force recommended colleges consider a ten-day vacation at least once a year for PG students, and said leave requests should be "judiciously considered and not unreasonably declined". If you haven't been home in months, asking for leave is reasonable, not weak.

Some small things residents do:

• A fixed video call with home, even ten minutes, even post-night.
• Finding one place in the new city that feels like yours: a tea stall, a temple, a park bench, a mess that makes food close to home.
• One friend in the batch from your region, to talk in your own language sometimes.
• Keeping one home habit going, like cooking one familiar dish on off days.

None of this removes the distance. It can make the week feel less empty. If homesickness has turned into not wanting to get out of bed, that's worth talking to someone about.

Residency is hard on relationships. You miss calls, cancel plans, come back too tired to talk, and your partner starts feeling like the last thing on your list. Sometimes it survives. Sometimes it doesn't.

If you're in a relationship: say what's happening before resentment builds. "I'm on nights all week, I'll be bad at texting, this isn't about you" prevents a lot of fights. Protect one small thing together each week, even a meal.

If you've just been through a breakup: it hurts, and you still have to round at 8 am. That's brutal. You're allowed to be sad on duty and still function. You could tell one person in your unit so someone knows why you're quiet. Try to keep sleep and food going, since both fall apart first after a loss.

Some things to avoid if you can: making big decisions (quitting, switching branch) in the first few weeks, and using alcohol or other substances to get through nights. The NMC survey found 19% of PGs felt the need to cope with stress through substances. That route tends to make things harder later.

If a breakup has left you feeling hopeless or unsafe, please reach out today. Tele-MANAS: 14416.

Your school group chat has moved on to weddings and jobs. Your MBBS friends are spread across six states. Someone's birthday went by and you only noticed three days later. It can feel like you're losing people one missed call at a time.

A lot of friendships don't end. They go quiet. Most old friends will understand residency, especially if they're in medicine too, and many will pick up where you left off when you have time again.

Some low-effort ways to keep them going:

• A voice note instead of a call. You can send it from the lift.
• One message a week to one person. That's it.
• Saying it straight: "I'm drowning in duty, not ignoring you. I miss you."

Also, new friendships count. The co-PG you share nights with, the senior who covers for you, the nurse you talk to at 4 am. Peer support shows up in the evidence on resident well-being, even though the studies are mostly small. The people in your unit can become your people.

If you've pulled away from everyone and it's been weeks, notice that. Withdrawing is one of the warning signs worth taking seriously.

Two residents together: someone who actually understands your day, and also someone whose day is as bad as yours. Two post-nights in one flat can be a lot. 😭

What tends to help:

• Share rosters as soon as they're out. Plan around them instead of hoping.
• Don't compete over who's more tired. You're both tired. Take turns being the one who's "on" at home.
• Keep one thing that isn't medicine. A show, a walk, a food place. If every conversation is about cases and HODs, it can start to feel like a second workplace.
• Talk about the big decisions early. Different cities for super-speciality, exam timelines, marriage timing and families' expectations. These are easier to discuss before they're urgent.
• Watch out for each other. You're well placed to notice if your partner is sinking. You may also be too close, or too tired, to be their only support.

It's okay if one of you needs outside help at some point. Being partners doesn't mean you have to be each other's therapist.

This card is written in plain words on purpose.

Your life is precious. It's worth more than any rank, exam, thesis, branch, marriage decision or loan. You were a whole person before medicine, and you still are.

The project owner asked us to say this directly: "Sometimes staying alive is more important than living. Things can obviously be sorted." Exams can be retaken. Branches can change. Money problems can be worked out over time. Family conflicts can soften. Losing you cannot be undone.

If you are having thoughts of suicide, or feel you would be better off not here, please do not keep it to yourself. Support and treatment help most people who have these thoughts. People do get through this, and many doctors have.

Call now:

• Tele-MANAS: 14416 or 1-800-891-4416 (free, 24x7, in many Indian languages)
• Vandrevala Foundation: +91 9999 666 555 (call or WhatsApp, 24x7)
• iCall (TISS): 9152987821 (Monday to Saturday, 8 am to 9 pm)
• Emergency: 112

You do not need to explain everything. You can say, "I'm not safe right now." Also tell one person near you: a co-PG, a senior, a friend or a family member.

Thank you for reading. Your child is doing some of the hardest work in medicine, and they may not tell you how hard it is.

What residency often looks like: The NMC task force survey found 45% of PG students work over 60 hours a week, 56% don't get their weekly off, and 84% report moderate to very high stress. Tiredness is not laziness or ingratitude.

Signs worth noticing:

• They've gone quiet, stopped calling or stopped sounding like themselves.
• Talking about being a burden to others.
• Withdrawing from friends and family.
• Sleeping too little or too much.
• Losing interest in things they used to enjoy.

What helps:

• Listen first. Ask, "How are you really?" and wait.
• Believe them the first time they say they're not okay.
• Say, "Your health matters more to us than any exam or rank."
• Support them seeing a counsellor or psychiatrist. It is a normal medical step.

What to avoid: comparisons with others, "think of what we sacrificed", or "we also struggled and managed."

If you're worried about their safety, contact them, stay with them if you can, and call Tele-MANAS (14416, free, 24x7) or emergency: 112.