Medical residencies begin at the postgraduate stage of one’s medical education. The first year of residency or “internship” depends on the specialty of choice and is usually either a year of internal medicine or general surgery. In some cases there can be a mix of both called a transitional year. The duration and demands of residency vary based on the specialty of choice. Internal medicine is a 3 year residency followed by a 1-2 year fellowship whereas Neurosurgery can be 6 years or more. Residencies themselves expose young doctors and medical students to a world of successful individuals excelling in the medical field, inspiring them to strive for success. However, the work that follows is often rigorous and demanding, leading to “burnout” amongst many of the best and brightest doctors. What starts as a dream to find success within the medical field can quickly turn into a desperate attempt to simply survive another sleepless night on call in the hospital.
According to a study conducted by Srijan Sen, MD, PHD, and Connie Guille, MD, depression rates dramatically increase among trainees within their first few months of residency, as well as feelings of anxiety and general burnout. Even more concerning, this study also found that the increase in mental health issues is not temporary. Dr. Sen and Dr. Guille both found that 1 in 4 residents screened positive for depression in varying stages of their residency, some being in their first few months while others being more experienced (eclipsing their first few years).
While burnout is certainly a large contributor to increased rates of depression and anxiety, medical errors and poor patient care have also been found to impact the mental health of Residents. The well-being of medical trainees and patients alike should be made a priority, which requires change, and, in Dr. Sen’s words, “reform at a much broader, systemwide level.”
An important statistic to take into consideration is the rate of depression at medical facilities which offer educational inpatient rotations. Residents that found these to be helpful and informative reported having significantly lower rates of depression and anxiety. Perhaps unsurprisingly, residents who worked more than 55 hours a week reported having much higher rates of depression, suggesting that reform in terms of mandatory working hours would be highly beneficial as well.
Flexibility and improved benefits are also very important in combating the historically negative mantra associated with medical residencies. Parental leave, daycare, and the ability to move schedules around for working parents is a benefit that has proven successful in nearly every industry. Additional support in general is required for this.
Increasing our support and improving the well-being of residency interns and trainees is not just critical for the medical industry as a whole, but an ethical obligation as well. Their jobs are to take care of those in need which cannot be done property when they are not taken care of themselves.
“It’s time to get serious about resident wellness.” Association of American Medical Colleges, August 9, 2019.
“Assessment of Inpatient Time Allocation Among First-Year Internal Medicine Residents Using Time-Motion Observations.” National Center for Biotechnology Information, June 1, 2019.