A simple model of stress, burnout and symptomatology in medical residents: A longitudinal study

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Abstract
A simple model of work stressors, perceived stress, burnout, affect, general health and clinical competence was tested in 46 internal medicine and surgical residents across the course of one year of residency training. As predicted by the model, increased perceptions of stress were associated with increased levels of both job- and patient-related burnout later in the residency year. This pattern was especially pronounced in male residents. Furthermore, increased levels of patient-related burnout were associated with greater mood disturbance, as well as poorer general health, while higher levels of job-related burnout were found among those individuals with the lowest ratings of clinical competency at the end of the residency year. Despite self-reported decreases in hours worked across the year, and increases in reported sleep, depression was found to increase in this group of residents. The results of the present study suggest that interventions designed to assess and address perceived stress, health, mood and level of burnout may be most effective in alleviating the professional and personal difficulties often associated with medical residency.