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April 2006 Issue

Michael Yi, MD, says that even though residents, such as Angela Brittsan, MD, (right) are working shorter days, they still run the risk for developing depressive systems.
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Research Gives New Clues for Improving Young Physicians' Health

Published April 2006

Medical residency could arguably be one of the most intense experiences during a young doctors career.

Popular television shows—sensational or not—have brought the lives of these trainees and their seemingly endless work schedules right into our living rooms. But there’s another side to the “drama.”

Studies from the past twodecades have linked medical residents’ long work hours to impaired driving, medical errors and even depression. Concerned also about potential effects on the residents’  education and patient care, the Accreditation Council for Graduate Medical Education(ACGME) addressed the problem in 2003 by imposing strict restrictions on residents'  hours.

Nevertheless, UC researchers say, the prevalence of significant depressive symptoms among residents has not decreased. What’s more, the researchers believe, it’s not only stressful work conditions that cause depression among residents. Their religious and spiritual feelings also appear to play a role.

Data collected through a survey suggested that the risk for significant depressive symptoms was greater among respondents who reported negative religious coping mechanisms, poorer spiritual wellbeing and the need for more spiritual support.

The study, which appeared in the March 2006 edition of Ambulatory Pediatrics, found that 25 percent of 227 primary-care residents surveyed reported a number of depressive symptoms, such as irritability, sense of isolation and hopelessness, and fear.

“Research from the last two decades has shown the prevalence of significant depressive symptoms among residents to be in the range of 20 percent,” says principal investigator Michael Yi, MD, ofUC’s internal medicine department.

“We might have expected that number to fall after the ACGME implemented work-hour restrictions, but our study found the level to be pretty consistent with earlier data.”

Of the four residency programs evaluated—pediatrics, internal medicine, family medicine and thecombined internal medicine/pediatrics program—the researchers found that residents in certain programs reported higher rates of significant depressive symptoms.

“Mood or other psychological problems among primary-care residents, or any other health-care provider for that matter, could negatively affect patient care,” says Dr. Yi. “Our findings suggest that screening residents for depression and other mood problems may be warranted.

“In addition,” he says, “addressing the spiritual needs of residents at greater risk for mood problems may help them cope with the stresses associated with their training.”

The study was funded by the National Center for Complementary and Alternative Medicine. Study coauthors included Sara Luckhaupt, MD, Joseph Mrus, MD, Caroline Mueller, MD, Amy Peterman, PhD, Christina Puchalski, MD, and Joel Tsevat, MD.

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