Effect of internet shutdown on postgraduate trainees in Manipur: A qualitative study

Background & objectives Internet shutdowns, although rare can be imposed by governments or affiliated entities and can intentionally disrupt online information and communication systems. While justified for maintaining public order, these shutdowns cause substantial economic losses, public suffering, and reputational damage. The internet shutdown in Manipur, initiated on May 3, 2023, due to civil unrest, has affected various sectors. The impact on doctors, amidst an era where internet access is considered as an integral part of practice, warrants deeper exploration of the challenges faced during such a prolonged shutdown period. Therefore, this study was conducted to explore the impact of internet shutdown among postgraduate trainees from two tertiary care hospitals in Manipur. Methods A study was conducted in two tertiary healthcare centers in Manipur from July to August 2023 among medical postgraduate trainees. Participants were selected using purposive sampling. Twenty-two in-depth interviews (IDIs) were conducted, recorded, and transcribed verbatim. Thematic analysis was done to identify codes, categories and themes. Results This qualitative study was undertaken among postgraduate trainees in two different academic institutes. A total of 21 IDIs were carried out. The major themes emerged from the study, namely, impact on professional life, impact on personal life, social consequences and coping. Internet shutdown affected patient care such as seeking timely opinions from consultants, delays in sharing patient reports and inconveniences in the hand-off process and the academic performance of postgraduate trainees like unavailability of study materials or keeping up with recent advancements. On a personal level, it negatively affected communication with family and friends, mental well-being and caused inconvenience in shopping and transactions. The study also found some positive impacts, such as less screen time leading to better sleep and increased physical activities. Interpretation & conclusions The findings of this study suggest that the internet shutdown significantly affected both the professional and personal aspects of postgraduate trainees' lives in Manipur. The implementation of a targeted ban on social media platforms and the establishment of designated internet access points are proposed as potential alternatives.