Internship: what is stressful?

We periodically evaluated 27 interns for mood states and psychophysiologic functions during their internship year. At the end of the year they were questioned as to what they had found to be stressful and/or supportive during the year. Stressful issues were inadequate sleep, inadequate time to pursue personal matters, and inadequate personal interest and support from attending physicians. Helping to reduce stress were support from, and camaraderie with, fellow house officers. Those interns who had more emotional distress experienced less support from others and felt more isolated. The amount of sleep did not differentiate those who were more dysphoric from those who had less distress. We conclude that the major issue in determining the amount of distress experienced during the internship is the quality of the individual's social support system.