The Silent Struggle: Depression During Residency

James A. Miller, MD


September 21, 2015

Entering residency should be a high point in the life of a training physician. In many ways, this step signifies the first payoff from the years of training and sacrifice inherent in medical education. This marks the time when we are first entrusted to make decisions that affect patient care and is an important milestone in our development as fully independent doctors. However, for too many young doctors, residency is a time punctuated by depression and burnout.

Our training years (including medical school and residency) are increasingly recognized as peak times for depression to take hold. In a survey of nearly 400 medical students, only about 60% reported normal levels of psychological distress.[1] The source of this distress isn't just the demanding workload: A French study found that poor perception of personal accomplishment and low job satisfaction were extremely common.[2]

The most serious effects of depression are obvious. Tragically, between 300 and 400 doctors take their lives each year.[3]

The impact isn't felt only among the residents themselves. Depression during residency can also lead to so-called "empathy fatigue"; this sensation can ultimately lead young doctors to forget their initial humanitarian ideals when entering the field. These symptoms can affect our decisions about how to practice in the future. In fact, residents who experience depression are less likely to suggest that they will treat Medicaid patients.[4]

People who suffer from depression often wait many years before seeking treatment, and doctors are no different. Although depression is present in the general population, the stigma associated with seeking treatment for it is even more prominent among medical professionals. Doctors in training learn early on that a diagnosis of depression can lead to loss of respect from colleagues and can even impair professional advancement.


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