Subject(s)
Education, Medical, Continuing , Accreditation , American Medical Association , Congresses as Topic , Credentialing , Education, Medical, Continuing/classification , Education, Medical, Continuing/economics , Humans , Licensure, Medical , Schools, Medical , Societies, Medical , Time Factors , Training Support , United StatesABSTRACT
We periodically evaluated 27 interns for mood states and psychophysiologic functions during their internship year. At the end of the year they were questioned as to what they had found to be stressful and/or supportive during the year. Stressful issues were inadequate sleep, inadequate time to pursue personal matters, and inadequate personal interest and support from attending physicians. Helping to reduce stress were support from, and camaraderie with, fellow house officers. Those interns who had more emotional distress experienced less support from others and felt more isolated. The amount of sleep did not differentiate those who were more dysphoric from those who had less distress. We conclude that the major issue in determining the amount of distress experienced during the internship is the quality of the individual's social support system.
Subject(s)
Internship and Residency , Stress, Psychological/etiology , Activities of Daily Living , Depressive Disorder/etiology , Humans , Interpersonal Relations , Medical Staff, Hospital/psychology , Perception , Prospective Studies , Sleep Deprivation , Social Isolation , Social Support , Stress, Psychological/prevention & control , Surveys and QuestionnairesABSTRACT
The internship is the focal point of the transition of medical student to physician. From its origins in hospital apprenticeships, this experience of professionalization and initiation into direct patient responsibility has followed an erratic path. Modern US internships began in the late 19th century, and evolution of many of their characteristics has been determined more by socioeconomic-political issues than by consideration of educational objectives. The recent move to incorporate internships into residency programs is currently being reconsidered because there is a new appreciation of the role that the internship experience can play in the professional maturation of the physician.
Subject(s)
Internship and Residency/trends , Accreditation/trends , History, 18th Century , History, 19th Century , History, 20th Century , Internship and Residency/history , Internship and Residency/legislation & jurisprudence , Licensure, Medical/history , United StatesABSTRACT
Previous reports have suggested that first-year graduate physicians have a high incidence of psychologic distress and may show cognitive impairment as a result of sleep deprivation. We periodically evaluated 27 interns during their training year to determine amount of sleep, mood states, reaction time, critical flicker fusion, and symptoms of depression. We found the incidence of major depression in our subjects (four of 27) to be lower than previously reported but higher than expected for that age group in the general population. Risk factors for depression during the internship year were history of major depression, female sex, and unmarried status. The only significant change in average mood state was that anger progressively increased during the year. Subjects slept an average of 5.95 hours per 24-hour day during the year. Correlational analysis indicated that, contrary to predictions, performance on reaction time and critical flicker fusion improved with less sleep. At the end of the year, subjects regarded the year as stressful but not more so than had been anticipated.
