Physician burnout and depression during medical residency

Physician burnout starts early in training.

I wrote last year that medical residents faced burnout, helped in part by the culture they train in:

… residents “from seven different specialties and found that they set themselves up for burnout by accepting, even embracing, what they believed would be a temporary imbalance between the personal and professional aspects of their lives.”

Recent studies have shed more light on the issue.

According to a study from the Archives of General Psychiatry, “fewer than 4% of doctors in training have major depression when they enter residency. But about 25% do by the end of the first year.”

Being depressed doesn’t help doctors care for patients. According to the study’s author, “It’s a really serious matter … We have to find ways to reduce the chances of developing depression and treating it once it comes on.”

Indeed, residency programs need to be proactive in identifying and treating physicians-in-training who are at risk of mental health issues. Because if it’s not addressed, it’s a burden that will only grow and follow the doctor long after he leaves the training environment.

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  • http://www.drjshousecalls.blogspot.com Dr. Mary Johnson

    The phenomenon extends past residency into fellowship and/or establishing a practice.

    Be it in fellowship or as an employee auditioning as a junior partner (or slaving for that elusive bonus from the local “non-profit”), you’re still a peon for a number of years – and the imbalances continue – particularly in small towns and rural areas. And even then, you can be thrown out with the trash if you talk back to the bigger fish in the little fetid pond.

    Been there done that. No one cared. And the fact that I’ve fought back so hard against what happened to me (in my own hometown) makes me “mental” in some people’s eyes.

    As for depression, I went there and did that too (at the end of residency): http://drjshousecalls.blogspot.com/2007/02/attention-mental-health-advocates-heres.html

    The problem with identifying and treating depression in physicians is that there is such an awful stigma attached. The medical profession and society itself talks out of both sides of their mouths. We’re supposed to come forward and seek treatment, but when we do we’re opening ourselves up to all kinds of ugly (I’ll get to that). And although I’ve not required a session on the couch or a happy-pill since 1995, I still cannot get disablity insurance OF ANY KIND.

    Getting back to the “all-kinds-of-ugly” (the stigma associated with be open & honest about these things), I’ve recently been the victim of a cyber-stalker . . . and openly took him on – to the point of having him charged and going to trial (last week).

    The blogger-turned-stalker (the self-styled “Child of a Borderline Mother” with “sociopathic tendencies”) has wallowed in lobbing the nasty innuendo against my mental stability.

    I sat in Court and was forced to read his assessment of my mental health & character (lobbed as a series of 27 e-mails into my Inbox last November), while he sat smug and silent. Lawyers sat in the back of the Courtroom snickering. Virtually none of the supporting evidence (which included his comments on blogs and in TV/newspaper interviews) about the extent of the malice was presented into evidence and (of course) he did not take the stand. The (North Carolina) statute could not have been MORE clear about the illegality of what this man did, but the judge found him “not guilty” (!?!), put back out into the blogs with barely a slap on the hand, and he’s started all over again.

    http://drjshousecalls.blogspot.com/2010/05/when-fecund-stench-permeates-courtroom.html

    I’ve been here for five years and all I really see is a lot of talking on the blogs. I don’t see a lot of doing – in other words, stories that are brought/known here (as mine is) making the jump to the MSM and the attention they need to faciliate real change.

    That’s the most depressing thing of all.

    I really need to write a book.

  • http://drsmithdeal.com Dr Charlie Smithdeal

    NO MORE DEPRESSION. Conditions during many residency programs are conducive to mild depression. Lack of exercise, poor nutrition (“fast” food literally grabbed on the run,) lack of sunlight, lack of balance in one’s life, near-constant pressure to perform in a new field. But guess what, it becomes worse after years in practice–Drs begin every conversation with “What’s wrong, Mary? Tell me what hurts today.” Fighting with insurance carriers to be able to pay one’s increasing rent, salaries, etc. And now Obamacare on the horizon, where the local post-office staff may wind up running our ERs. The answer for me was to find a reasonable way to earn more more with less effort, NO MP concerns, and a minimum of government intervention. I enjoyed practicing medicine for years. No more. It’s only depressing now when I think about how it used to be.

  • http://www.workengagement.com/crew Michael Leiter

    Physician burnout is a serious and pervasive problem.
    Two things drive burnout: overwhelming workload and value crises.

    Physicians actually like work, so the issue isn’t the demands of medicine. Workload is overwhelming when docs lack the resources to meet that demand. A key resource is the doctors’ personal energy. A lifestyle that lacks balance necessary for health will deplete their personal energy.

    Value crises occur for docs who conclude that they’re working in a system that runs contrary to their person commitment to professional ideals. People will undergo an extraordinary amount to pursue their core beliefs, but burn out when that spark is missing.

    Here’s a research report on demands and values with burnout: http://www.cfp.ca/cgi/content/full/55/12/1224

    Here’s more about job burnout:
    http://www.workengagement.com/component/content/article/34-burnout/160-doctors-burnout

    All the best,
    Michael
    http://www.workengagement.com

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