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Study shows long working hours put new medical residents at risk for depression

Everyone who watched ABC Grey’s Anatomy knows that the life of a first-year doctor, colloquially known as “interns”, is arduous to say the least. Mindless paperwork, long hours, and relentless stress are hallmarks of the experience. While stress in health care is not uncommon, researchers have found that first-year medical residents experience increased rates.

Srijan Sen, Director of Eisenberg Family Depression Centerand lab lead researcher Yu Fang conducted to research using surveys and data from 2009 to 2020. The total number of participants was approximately 17,000 trainees.

The polls followed a Rating PHQ-9 — a score based on a set of questions monitoring the severity of patients’ depression and their response to treatments — that gave researchers an idea of ​​who might be at risk for depression. On the tally sheet, a number greater than nine is considered to be at moderate risk for depression. Interns who volunteered to participate in the surveys would complete them during their final semester as an intern before becoming a first-year physician.

According to the study, 33.4% of trainees who met criteria for depression worked more than 90 hours per week, showing a correlation between work hours and depression. Symptom scores were almost three times higher for those who worked more than 90 hours per week than for those who worked 40 to 45 hours per week.

The study proposed to have more employees in the workforce and to ensure that doctors do not work more than 80 hours a week to help reduce the risk of depression. Sen said having more staff would help currently overworked doctors have a more balanced schedule.

“There have been advances over the past few years in reducing workload, and we’ve seen a corresponding decrease in depression,” Sen said. “But there is a lot more to do.”

Second-year resident physician at Michigan Medicine Stefanie Stallard participated in the survey and said first-year residents don’t have enough time to learn about their jobs. She said most of the stress first-year residents face can come from feeling unprepared when transitioning from internship to practicing physician.

“(Resident doctors) have a whirlwind orientation that is really about logistics more than anything, like making sure you have your badge,” Stallard said.

Stallard said focusing only on reducing the workload and working hours of doctors, especially first-year medical residents, is not enough to combat the stress they face. She said while it’s important to consider the correlation between working hours and the risk of depression, it’s not the complete picture because it’s hard to say exactly what ‘working hours’ means. for an individual resident.

“For example, you work 12 hours a day; are those 12 hours when you have to take a break and have lunch? …or is it 12 hours where you’re just frantically, nonstop, trying not to drown in the amount of work you have? Stallard said.

Stallard said providing more help for interns and first-year doctors to transition into the workforce would help reduce residents’ stress levels. Stallard drew on her experience transitioning from first to second year in residency and said the orientation they called “boot camp” was part of what helped her transition into second year. . Part of the orientation was practice time to review topics residents needed to know, in what Stallard described as a learning environment.

“Just being exposed to things to get educational reminders of things that we’re going to see when we’re working with patients has taken a certain edge on this transition into starting neurology,” Stallard said.

Stallard says he has more conversation surrounding mental health for doctors is a good way to address the risks of depression and was happy to have Michigan Medicine talking about mental health.

“I’m really glad people are looking into (doctors’ risks of depression) and posting stories,” Stallard said. “Because it’s a conversation that needs to happen.”

Tasha Hughes, an assistant clinical professor specializing in surgery at Michigan Medicine, said while study researchers have been following surveys for a long time, it’s hard to say whether this increase in work hours was caused by the COVID pandemic. -19. Hughes said while the data isn’t new, it’s worth noting the number of first-year medical residents at risk for depression.

“We still see about a third of interns, 32% of interns, who start out as non-depressed, experience depression at at least one of these checkpoints throughout their internship year based on their PHQ-9 score” , said Hughes. “So we think it’s a pretty big issue.”

Hughes said that while how mental health is discussed varies from department to department, it’s still important for Michigan Medicine to take steps to address residents’ mental health issues. Michigan Medicine Home Mental Health Officer Program is one such initiative that offers support to residents.

“We have different roles and programs in place that address both resident health and wellness, and mental health is one of them,” Hughes said. “Some (of the goals) include controlling your time, finding value or meaning in your work, and reducing workplace harassment or unfair treatment for residents.”

Fang, a senior neuroscientist at Michigan Medicine, said rates of depression among medical residents are a problem that needs to be addressed not just in the United States, but around the world.

“Although the data is (based on) only American trainees, I think it’s not just the American medical system that has to fight this battle,” Fang said. “I think it’s a global problem that at least young doctors or medical trainees suffer from.”

Yu also said the health care system as a whole could help fight depression by providing more support for new first-year doctors.

“I think what the medical system as a whole could do is try to reduce the burden (on doctors) to make their work more efficient,” Yu said. “At the same time, make sure that they have sufficient training. (Make sure) they can learn what they need to learn, but reduce some unnecessary burdens.

While coping with mental health and depression is a risk resident doctors take during their rotations, LSA freshman Sikander Choudhary says the issue affects everyone, even those who don’t part of the medical field.

“It’s important to take care of yourself, especially if you’re someone who takes care of others,” Choudhary said.

Daily staff reporter Ji Hoon Choi can be reached at [email protected]