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December 2021, Volume 71, Issue 12

Letter to the Editor

On-campus counselling for medical student's mental wellbeing: A pressing priority

Unzila Khan  ( Department of Vascular Surgery, Dr. Ruth K.M. Pfau Civil Hospital, Karachi, Pakistan. )
Tayram Bint-e-Khalid  ( Department of Surgery, Dr. Ruth K.M. Pfau Civil Hospital, Karachi, Pakistan. )
Sumayyah Saee  ( Department of Vascular Surgery, Dr. Ruth K.M. Pfau Civil Hospital, Karachi, Pakistan. )



Madam, mental health is an essential component of a wholesome life. However, if disregarded, it may lead to stress, depression and even suicide. Although well aware of the importance of mental well-being, research depicts that medical students are prone to psychological morbidities, with one meta-analysis reporting a 27.2% prevalence of depression or depressive symptoms and an 11.1% prevalence of suicidal ideation.1 Similarly, another study conducted at Nishtar college predicts a high prevalence of both anxiety and depression (43.89%).2  Thus, the ramifications are far-reaching; ranging from a medical school dropout, impaired ability to work efficiently, burnout and increased suicidal tendencies.2  All this exacerbates effective healthcare provision.2

Medicine is a demanding field with more stringent levels of psychosocial, personal and academic stressors. The difficult and lengthy curriculum allows limited time for relaxation, sleep, friends and family. Also, students starting their clinical rotations during the current pandemic feel vulnerable and worried about patient contact. Thus, medical students are stressed-out, and this is evident by problems like substance abuse, burnout and suicides, yet we as a society feel handicapped.3

In these challenging times, necessary measures need to be taken by education administrators for the mental well-being of students. We suggest on-campus counselling as one such solution. Counselling is the provision of professional assistance and guidance in resolving personal or psychological problems.4  Throughout the world, on-campus counselling facilitates students in discussing issues ranging from studies-related stress to depression. The therapist, in turn, ensures confidentiality, support without any judgements or criticism and no fear of adverse effects on one's grades. They also equip students with guidance and stress coping strategies.

Thus, counselling effectively shuns the taboos associated with mental health, is a form of primary prevention against suicide and solves problems like stress etc. This nips substance abuse, anxiety and depression in the bud. Since, suicide is illegal by law, so help-seeking behaviour is often limited. Through counselling, we can identify such students at risk and intervene.

Regrettably, our students are bereft of this option; they battle their inner demons themselves or turn to substance abuse and/or self-harm/mutilation for escape. Thus, opportunities must be provided for students to identify, discuss, and manage their personal issues. Realizing this, institutions like Dow medical amended their policies and initiated counselling from 2018 onwards.5  However, many colleges are still lagging. Thus, it is high time we invest in approachable on-campus counselling services that facilitate students with coping strategies and enable them to become competent healthcare professionals.


Disclaimer: None to declare.

Conflict of Interest: None to declare.

Funding Disclosure: None to declare.




1. Rotenstein L, Ramos M, Torre M, Segal J, Peluso M, Guille C et al. Prevalence of Depression, Depressive Symptoms, and Suicidal Ideation Among Medical Students. JAMA 2016; 316: 2214.

2. Jadoon NA, Yaqoob R, Raza A, Shehzad MA, Zeshan SC. Anxiety and depression among medical students: a cross-sectional study. J Pak Med Assoc. 2010; 60: 699–702.

3. Final year medical student commits suicide. [Online] [cited 6 March 2019]. Available from: URL: medical-student-commits-suicide/.

4. Counselling. Definition of counselling in English by Oxford Dictionaries. [Online] [cited 9 February 2019]. Available from: URL:

5. Circular [Online] 2018 [cited 11 February 2019]. Available from URL:

Journal of the Pakistan Medical Association has agreed to receive and publish manuscripts in accordance with the principles of the following committees: