Stress in residency: a challenge to personal growth.

Postgraduate residency training requires young physicians to make the difficult transition from student to doctor. Recent evidence suggests that this period is associated with significant depression, anger, cynicism and emotional withdrawal, and there are concerns about its effect on the attitudes and future functioning of physicians. The perceived stresses are not unique to physicians and represent, in part, a need for personal growth that is common in the human service professions. Training programs can be more helpful to residents as they move through this transition. More attention must be paid to needs for sleep and time away from the hospital. Residents require more support and guidance in the personal aspects of becoming a physician, and programs can do much better at helping residents develop the communication skills needed to be an effective physician. The benefit of these efforts may be the development of physicians less likely to become impaired and more likely to give competent humane care to their patients.