Overhaul of graduate medical education needed to help resident depression

By Aine Cryts

A whopping 21 to 43 percent of medical residents suffer from depression, according to an article published in JAMA.

The prevalence of depression among medical residents increases with each passing year, wrote Douglas Mata, M.D., the study's lead author and a resident physician at Boston's Brigham and Women's Hospital. And this is after the Accreditation Council for Graduate Medical Education and other groups have worked to reduce trainee duty hours, he noted.

"As clinicians, we're used to treating others, but we're often bad at taking care of ourselves," Mata told MedPage Today. "We can spot public health crises in our patients, but haven't done so enough within our own medical community. Doctors need to pay more attention to their own mental wellbeing and that of their colleagues," he added.

And the emotional state of residents matters: Depression in residents has been associated with poor quality of patient care and an increase in medical errors, wrote Thomas Schwenk, M.D., dean of the University of Nevada School of Medicine, in an accompanying opinion piece in JAMA. He called attention to what he described as a "depression endemic among residents and fellows."

The harshness of the medical school experience also needs to be improved, suggests a recent NPR article illustrating, literally, that medical students perceive their supervisors as monsters. 

To fix this paradigm, an overhaul of the graduate medical education training system is in order, Schwenk wrote. The study's co-authors made the following recommendations:

  • Assess residents for depression before they start their training
  • Teach residents to manage the stress of their medical training via a year-long resilience-based program 
  • Conduct ongoing measurement of residents' long-term coping skills and support for struggling residents

Rapidly changing and increasingly strict protocols for patient care are making everyone frantic in medicine today, Schwenk told NPR. He called for a more personalized training approach for residents--one that incorporates dedicated teaching and mentorship--after medical school.

To learn more:
- here's the JAMA article and the commentary
- read the MedPage Today article
- check out the NPR article