The lived experiences of postgraduate medical residents in managing high patient turnover in the emergency departments of government hospitals in Pakistan

Abstract

Background: High patient loads in the emergency departments (EDs) of government hospitals in Pakistan place considerable stress on healthcare providers, particularly postgraduate medical residents. These trainees face the combined pressures of patient care, administrative responsibilities, and personal stress, which can adversely affect both their clinical performance and mental well-being.

Objective: To explore and compare the experiences of postgraduate medical residents managing high patient turnover in the emergency departments of government hospitals in Pakistan.

Methods: This qualitative comparative study was conducted in the Casualty Department affiliated with the Department of Medicine at Ayyub Teaching Hospital, Abbottabad. A purposive sample of 10 postgraduate medical residents from various government hospitals was recruited. Data were collected through semi-structured in-depth interviews (IDIs). The interview transcripts were analyzed thematically to identify similarities and differences in residents' experiences across the participating hospitals.

Results: Most residents reported that high patient volumes, inadequate resources, and excessive workloads placed them under significant pressure. Emotional exhaustion, impaired clinical decision-making, and insufficient institutional support emerged as major themes. Although several residents adopted personal and peer-supported coping strategies, they continued to experience substantial emotional and physical stress. The lack of organizational support further increased their cognitive and emotional burden, adversely affecting their well-being and professional confidence.

Conclusion: This study highlights the need for structural and organizational reforms to improve the working conditions of postgraduate medical residents in high-turnover emergency departments. Sustainable strengthening of emergency healthcare services in Pakistan's government hospitals requires investment in human resources, improved healthcare infrastructure, and accessible mental health support services for healthcare professionals.