Literature DB >> 11874311

Stress in medical residency: status quo after a decade of reform?

Virginia U Collier1, Jack D McCue, Allan Markus, Lawrence Smith.   

Abstract

BACKGROUND: Although curricular reforms have attempted to address sources of stress in medical residency, no recent studies have examined the financial or emotional situations of current medicine residents.
OBJECTIVE: To question medicine residents about financial status, educational debt, moonlighting, and psychological issues.
DESIGN: Survey distributed in a nonrandomized fashion to medicine residents.
SETTING: All 415 U.S. medicine residency programs.
RESULTS: According to the questionnaire responses submitted by the 4128 (18%) participating residents, a substantial number of residents had financial and emotional distress that could have interfered with training. The reported educational debt was at least $50 000 for 1657 (42%) of the respondents and at least $100 000 for 737 (19%). The monthly disposable income was $100 or less for 1620 (43%) of the residents, and 637 residents (16%) could not afford safe housing. Among respondents in their 2nd through 5th year of postgraduate training, 2187 (52%) had insufficient funds to purchase books and equipment, and 678 (29%) could not afford the required fees for the American Board of Internal Medicine certifying examination; 2659 (33%) worked as moonlighters, and this percentage increased progressively with increasing educational debt. Four or five depressive symptoms during residency were reported by 1461 (35%) residents. Eight hundred ninety-nine residents (23%) thought they had become less humanistic over the course of their residency training; 2347 (61%) reported becoming more cynical. Female residents were more likely than male residents to report increased cynicism and multiple depressive symptoms. Increased cynicism and depressive symptoms were associated with increasing educational debt.
CONCLUSIONS: Despite recent curricular reforms, an alarming number of current medicine residents report depressive symptoms, increasing cynicism, and decreasing humanism, which were associated with increasing educational debt and a need to moonlight for financial survival. Ongoing curricular reform, legislative relief from early loan repayment, and salary increases may be necessary to address these problems.

Entities:  

Mesh:

Year:  2002        PMID: 11874311     DOI: 10.7326/0003-4819-136-5-200203050-00011

Source DB:  PubMed          Journal:  Ann Intern Med        ISSN: 0003-4819            Impact factor:   25.391


  65 in total

1.  On the Edge of Life, II: House Officer Struggles Recorded in an Intensive Care Unit Journal.

Authors:  Mikkael A. Sekeres; Theodore A. Stern
Journal:  Prim Care Companion J Clin Psychiatry       Date:  2002-10

2.  Burnout during residency training: a literature review.

Authors:  Waguih William Ishak; Sara Lederer; Carla Mandili; Rose Nikravesh; Laurie Seligman; Monisha Vasa; Dotun Ogunyemi; Carol A Bernstein
Journal:  J Grad Med Educ       Date:  2009-12

3.  Promotion of Wellness and Mental Health Awareness Among Physicians in Training: Perspective of a National, Multispecialty Panel of Residents and Fellows.

Authors:  Timothy J Daskivich; Dinchen A Jardine; Jennifer Tseng; Ricardo Correa; Brian C Stagg; Kristin M Jacob; Jared L Harwood
Journal:  J Grad Med Educ       Date:  2015-03

4.  Residency as a Social Network: Burnout, Loneliness, and Social Network Centrality.

Authors:  Jordan Shapiro; Bin Zhang; Eric J Warm
Journal:  J Grad Med Educ       Date:  2015-12

5.  Completing a scholarly project during residency training. Perspectives of residents who have been successful.

Authors:  Josette A Rivera; Rachel B Levine; Scott M Wright
Journal:  J Gen Intern Med       Date:  2005-04       Impact factor: 5.128

6.  A description and qualitative assessment of a 4-year intervention to improve patient counseling by improving medical student health.

Authors:  Erica Frank; Donna Smith; Dorothy Fitzmaurice
Journal:  MedGenMed       Date:  2005-05-02

7.  Mentoring matters. Mentoring and career preparation in internal medicine residency training.

Authors:  Radhika A Ramanan; William C Taylor; Roger B Davis; Russell S Phillips
Journal:  J Gen Intern Med       Date:  2006-04       Impact factor: 5.128

8.  Work stress and reduced health in young physicians: prospective evidence from Swiss residents.

Authors:  Barbara Buddeberg-Fischer; Richard Klaghofer; Martina Stamm; Johannes Siegrist; Claus Buddeberg
Journal:  Int Arch Occup Environ Health       Date:  2008-02-12       Impact factor: 3.015

9.  Residents' experience of scholarly activities is associated with higher satisfaction with residency training.

Authors:  Osamu Takahashi; Sachiko Ohde; Joshua L Jacobs; Yasuharu Tokuda; Fumio Omata; Tsuguya Fukui
Journal:  J Gen Intern Med       Date:  2009-04-25       Impact factor: 5.128

10.  Toil and trouble?: should residents be allowed to moonlight?: yes.

Authors:  Sarita Verma
Journal:  Can Fam Physician       Date:  2008-10       Impact factor: 3.275

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