Stress and Impairment during Residency Training: Strategies for Reduction, Identification, and Management
Journal: Annals of Internal Medicine (1988)

Academia and Clinic15 July 1988Stress and Impairment during Residency Training: Strategies for Reduction, Identification, and ManagementAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-109-2-154 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail AbstractAbstractGraduate physicians face formidable developmental tasks during residency training as they prepare for their professional careers. Adapting to becoming a skilled physician involves assuming and mastering many professional responsibilities for the proper care of patients while taking on many personal obligations such as marriage, parenthood, and financial independence. Adaptation requires physicians to cope successfully with a series of stresses that have been divided into three categories: situational, professional, and personal stresses. Each category is reviewed and both general and specific recommendations are offered to reduce the level of stress. Normal and abnormal responses to the stresses of residency training are described, and guidelines are provided for recognizing the impaired resident early. Recommendations are made for managing the residency program and treating the resident, should he or she become impaired.References1. Martin A. Stress in residency: a challenge to personal growth. J Gen Intern Med. 1986;1:252-7. CrossrefMedlineGoogle Scholar2. Brent D. The residency as a developmental process. J Med Educ. 1981;56:417-22. MedlineGoogle Scholar3. Linn L. Career orientations and the quality of working life among medical interns and residents. Soc Sci Med. 1981;15:259-63. Google Scholar4. McCue J. The distress of internship: causes and prevention. N Engl J Med. 1985;312:449-52. CrossrefMedlineGoogle Scholar5. Reuben D. Psychological effects of residency. South Med J. 1983;76:380-3. 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The natural history of emotional changes for a class of internal medicine residents. Clin Res. 1986;34:818A. Google Scholar21. Residents' Rights and Resources Booklet Resident, Physicians Section. Chicago: American Medical Association; 1986:43-56. Google Scholar22. SmithDennyWitzke JWD. Emotional impairment in internal medicine house staff. JAMA. 1986;255:1155-8. CrossrefMedlineGoogle Scholar23. UlianaHubbellWyle RFF. Mood changes during the internship. J Med Educ. 1984;59:118-23. MedlineGoogle Scholar24. ValkoClayton RP. Depression in internship. Dis Nerv Syst. 1975;36:26-9. MedlineGoogle Scholar25. Reuben D. Depressive symptoms in medical house officers. Arch Intern Med. 1985;145:286-8. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: *This paper was developed for the Association of Program Directors in Internal Medicine by the Resident Services Committee: Richard D. Aach, MD, Chairman; Thomas G. Cooney, MD; Donald E. Girard, MD; David Grob, MD; Jack D. McCue, MD; Malcolm I. Page, MD; John D. Reinhard, MD; David B. Reuben, MD; and Jay W. Smith, MD. This paper was adopted by the Council of the Association of Program Directors in Internal Medicine on 29 February 1988. Presented 1 December 1987 at the Plenary Session of the meeting of the Association of Program Directors in Internal Medicine, Philadelphia, Pennsylvania. 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Quill, MDWorking Conditions and Supervision for Residents in Internal Medicine Programs: RecommendationsBetter Housestaff SchedulesBrent Brown, MD, Robert Whang, MDFinancial Help for HousestaffBohdan A. Oryshkevich, MD, MPHStress in ResidencyGeorge Wesley, MDCauses and Treatment of Impairment and Burnout in Physicians: The Epidemic Within 15 July 1988Volume 109, Issue 2Page: 154-161KeywordsGraduate medical educationPatientsResidency ePublished: 1 December 2008 Issue Published: 15 July 1988 Copyright & Permissions© 1988 American College of PhysiciansPDF downloadLoading ...