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A common statement uttered by every nervous care-seeker, “We are awaiting test results”. But what goes on the other side of the waiting? What are the experiences of those who work while we wait, or rather, who work knowing that we wait?
Pathologists, the ones who work during that wait, are a pivotal part of the medical fraternity, holding an indispensable responsibility which is tied to every domain of healthcare. Expertise, accuracy, urgency and endurance, which are all highly demanding attributes, could be considered salient factors that the job entails.
The post-covid world has brought the mental health experiences of the general healthcare community to light. A review of over 100 Indian studies highlighted that more than half of the surveyed doctors demonstrated significant levels of depression and anxiety, contributed to by the stress of occupational demands (Ram & Mathew, 2025).
The mental health experiences of pathologists are identified to be diverse; on one hand pathologists experience one of the highest levels of job satisfaction (Chiou, 2021), and on the other hand, distinctive concerns related to occupational and systemic factors are reported.
A few highlights from the literature include unique issues, such as; a noticeable risk of musculoskeletal problems, injuries, visual disorders, and ergonomic issues (Khan, 2023), systemic issues such as lack of autonomy, excessive workload; especially in low-resource Indian settings, emotional exhaustion, lack of recognition, and administrative complexity (Khatab et al., 2024). The mental health stress on pathologists working in the area of forensics, paediatrics and oncology are particularly attended to, as the task calls forward one to repeatedly separate their “practitioner-self” from their “human-self.”
Yet, to truly dissect these two parts; the practitioner and the human, and to bring forward a filtered version of ourselves to our practice is challenging, and possibly also less effective. Instead, to use the humane parts of the practitioner, to tend to our human experiences, and to strengthen one part so it may better support the other, seems like a more pragmatic and an enjoyable reality. In fact, even the World Health Organization has reiterated that care, compassion and stability are imperative for the welfare of care-providers (WHO, 2024).
But how can we integrate these ideals into the already stalked shelves of the pathologist’s agenda? The answers are simple, practical and promising.
Myths About Caring for Our Mental Health
Care-providers often feel:
Mental health-care is selfish
Being angry, sad or feeling other emotions is a sign of weakness
Mental health care takes time and is a luxury
My mental health is not as important as my work
But here’s the truth:
Emotions are a very normal part of being a human and a practitioner
Your mental health is directly associated with your productivity
Self-care is an attitude and can be practiced through simple strategies
Creating Openness to Our Internal Experiences
Striving for high standards on a daily basis, doctors endure emotional pain, which can have compounding effects on their health and work.
Pathologists, particularly, interpret suffering repeatedly through malignancies, margins, and microscopic evidence of disease, the impact of which can be subtle but lasting.
A gentle starting point may be to ask ourselves; does this resonate with me? Have I paid attention to how I am feeling?
If you paused and asked yourself that question, that is already a step in the direction of self-care!
A simple extension entails; at the start and end of your day, possibly before you sign in and sign out of work, check-in with yourself. Creating space in our minds to Monitor feelings that come up; tiredness, frustration, anxiety, etc., paves a gentle yet reliable way for the steps to follow.
Whatever emotions arise; ask yourself “What is one thing that could help me feel better right now?”
Taking a walk, deep breathing, engaging in a hobby, spending time with family or sharing concerns with a friend? Even a small act of self-care can create noticeable changes for day-to-day stressors.
Combating Fatigue: Reimagining and Creating Space
One of the commonly reported concerns by pathologists include cognitive and physical fatigue. The need to constantly make decisions about findings and reports can create decision fatigue, which is augmented by the need to sustain attention over long periods of time, the effects of which are exacerbated by a physical environment which is less suitable.
In order to ensure accuracy and reduce errors, scheduling micro-breaks is found to be highly beneficial. Example: A 5-minute break for every 30 minutes of focussed work.
Estimating attention span and scheduling mandatory breaks at reaching the time mark, can be highly beneficial in building endurance. For instance, Dr. Kapil knows his average attention span is 40 minutes. He voluntarily plans tasks only for 40 minutes, after which he takes a scheduled 10-minute break.
Alternating tasks can also be a useful strategy to reduce fatigue and introduce novelty. Example: testing, followed by reporting, and then teaching.
Practicing Ergonomic awareness; making changes to the environment, improving lighting, ventilation, space, ensuring supportive chairs, laptop stands, etc. can have a surprising impact on our mood and comfort while working.
Negotiating ME vs US: Managing Isolation and Assurance
Pathologists report a shared experience of feeling isolated at work. Additionally, the lack of consistent opportunity for direct interaction with care-receivers can also create a detached experience for many.
Reframing the role:
Creating internal reframes to acknowledge your role helps to create a balanced and positive perspective:
“Treatment begins with my work”
“My diagnosis has a meaningful role to play in my patient’s recovery”
“I am not distant- I witness disease with a different degree of closeness”
Building connections is one of the best ways to combat isolation:
Enriching the quality of interaction with patients, irrespective of its quantity
Following up with collaborating doctors where possible to create and maintain feedback loops
Sharing the struggle with peers who have similar experiences can reduce the burden
Intentionally curating opportunities for engagement in formal and informal settings can also be beneficial
Systemic Considerations for Building Sustainable Practice
Mental health care does not rest solely on the individual’s shoulders. Hospitals and clinics also have a responsibility to foster environments that support staff well-being to reduce burnout and improve staff efficiency and welfare. This includes:
Shifting narratives from perfectionism, which can induce stress, shame and guilt: to precision, reflection and mentorship
Reasonable caseloads to ensure work quality
Micro breaks between work to reduce errors and improve accuracy
Space for open peer reflection and discussion of cases to improve learning
Avenues for open conversations about systemic challenges
Reducing occupational hazard due to exposure and improving the quality of the work space
One strategy that has been successfully used in several health care facilities is a Balint group; a specialized, confidential, small-group setting where pathologists meet regularly to discuss the emotional and relational aspects of their work, specifically focusing on interactions with clinicians, patients, and the stress of diagnostic uncertainty. Balint groups are highly beneficial in reducing burnout, improving work quality, resilience, group cohesion, and job satisfaction.
There is scope for attending to our own mental health even in small ways which can create big changes. At times when additional resources are required, professional help is also always available. Mental health care can and needs to be built into the day-to-day work ecosystem of all healthcare providers, especially pathologists who form the foundational core of patient welfare.
In a profession that depends on clarity, precision, and sustained attention, your mind is not separate from your work, it is the very instrument of it. Caring for yourself is an integral investment towards a lasting, successful and fulfilling career!
Additional resource:
Doing what matters in times of stress: https://www.un.org/sites/un2.un.org/files/2020/05/who_doing_what_matters_in_times_of_stress.pdf
https://www.tandfonline.com/doi/epdf/10.1080/10408363.2023.2285284?needAccess=true
References:
Chiou PZ. (2021). Exploring staff turnover, burnout, and resilience in cytology reference laboratories: A workforce qualitative study. Cytopathology,32:738–750. https://doi.org/10.1111/cyt.13024
Khan, S. (2023). The dark side of being a pathologist: Unravelling the health hazards. Indian Journal of Pathology and Microbiology. https://doi.org/10.4103/ijpm.ijpm_1148_21
Khatab, Z., Hanna, K., Rofaeil, A., Wang, C., Maung, R., & Yousef, G. M. (2024). Pathologist workload, burnout, and wellness: Connecting the dots. Critical Reviews in Clinical Laboratory Sciences, 61(4), 254–274. https://doi.org/10.1080/10408363.2023.2285284
Ram, D., & Mathew, A. (2025). Mental Health Challenges Among Doctors in India: A Scoping Review of Existing Research. Indian Journal of Psychological Medicine, 02537176251349766. https://doi.org/10.1177/02537176251349766
World Health Organization. (2024). Self-care for health and wellbeing. Retrieved from https://www.who.int/news-room/fact-sheets/detail/self-care-health interventions#:~:text=WHO%20recognizes%20the%20value%20and,Sustainable%20development%20Goals%20(SDGs)
Ashwathi P. G.
Ashwathi P. G.
Clinical Psychologist
Currently pursuing PhD in the Department of Clinical Psychology
National Institute of Mental Health and Neurosciences (NIMHANS)
Dr. Geetha Desai
Dr. Geetha Desai
Professor
Department of Psychiatry
National Institute of Mental Health and Neurosciences (NIMHANS)
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