Heeding the Plea To Deal with Resident Stress

• Internship and residency
• Stress, psychological
• Job satisfaction
• Depression
• Financing, government

In the old days—let's say 30 or 40 years ago—concerns about the well-being of medical residents centered on such issues as adequate parking spaces, midnight snacks, and off-hours access to the library. The pace of life was a lot slower, and the stresses were a lot more manageable. This is not to say that a resident's life was “a piece of cake” back then. We all worked long hours, routinely spent every other night and every other weekend in the hospital, had precious little time for “leisure activities,” were paid next to nothing, and worried a lot about money. But, as I recall, we were a pretty happy lot. The feeling of camaraderie was intense, the light at the end of the tunnel was clearly visible, and we were totally caught up in the excitement of caring for our own patients and learning how to be good physicians. On balance, the hardships were more than offset by the satisfactions.

I confess that my recollections of residency may have acquired the gloss of rosy retrospection, but I'm quite sure that the psychological state of my contemporaries was much less troubling than appears to be the case for residents today. The stresses, both professional and personal, that residents now experience do seem to be much more intense than in the past: Patients are sicker, hospital stays are shorter, and attendings are more hassled; many more residents are married, many have children, and a great many more are women. All of these contemporary realities are potential sources of added stress.

To make matters worse, the sources of offsetting …