Acute Care/Hospitalization

Experience, career satisfaction, and fewer work hours lead to less stress for attending physicians

Making the transition from medical student to medical resident can be a stressful adjustment. However, as interns, residents, and attending physicians advance in their residencies and become more adept at their careers, their stress levels decline, a new study finds. Timothy R. Dresselhaus, M.D., M.P.H., of the University of California, San Diego, and colleagues, asked 185 interns (first-year residents), residents, and attending physicians to record real-time mood assessments on hand-held computers over an 18-month period at 4 teaching hospitals in San Diego.

Attending physicians worked fewer hours (8.9 hours) than interns (10.4 hours) and residents (10.5 hours) and had more patients (9.7) assigned to them than residents (7.7 patients) and interns (5 patients). However, attending physicians had much lower stress ratings compared with interns and residents. The authors suggest that attending physicians may be well matched in their career choices, and their clinical decisionmaking experience reduces their stress, despite short workdays in which they see many patients.

Poor sleep quality and high patient load were associated with increased stress. To combat stress, the authors recommend that medical educators teach students to recognize stress, residents receive training in leading and supervising interns, and interns receive training in time management. This study was funded in part by the Agency for Healthcare Research and Quality (HS14283).

See "Intern to attending: Assessing stress among physicians," by Erin R. Stucky, M.D., Dr. Dresselhaus, Adrian Dollarhide, M.D., and others in the February 2009 Academic Medicine 84(2), pp. 251-257.

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