Background: Many studies have recognized that the first postgraduate year (PGY-1) of residency training is the most stressful. Failing to cope with the stress will have a negative impact on their work performance and the quality of patient care.
Aims and objectives: To investigate stress and burnout in PGY-1 residents and to explore the relationship between stress, coping strategies, and burnout.
Methods: Fifty-four PGY-1 residents completed the Perceived Stress Scale, the Copenhagen Burnout Inventory and Coping Inventory at baseline and after 6-month follow-up. The association among stress, burnout, and coping strategies was examined by paired t-test.
Results: PGY-1 resident students had an increase in the level of perceived stress, level of personal burnout, work-related burnout, and patient-related burnout from baseline to 6-month follow-up (p >0.05). In male resident doctors, only work-related burnout increased significantly with the duration of residency, while in females, a significant increase in the level of personal, work-related and patient-related burnout was observed.
Conclusion: The present study revealed high levels of stress that are predictor of burnout, which increases with the duration of the residency program.
CMA National Physician Health Survey: a national snapshot. Ottawa: Canadian Medical Association; 2018.
Larsson L, Rosenqvist U, Holmstrom I. Being a young and inexperienced trainee anesthetist: a phenomenological study on ought to working conditions. Acta Anaesthesiol Scand 2006;50(6):653–658. DOI: 10.1111/j.1399-6576.2006.01035.x.
Sahasrabuddhe AG, Suryawanshi SR, Bhandari S. Stress among doctors doing residency : a cross-sectional study at a tertiary care hospital in the city of Mumbai. Natl J Community Med 2015;6(1):21–24.
Agrawal S. Prevalence of stress among resident doctors working in Medical Colleges of Delhi. Indian J Public Health 2010;54(4):219–223. DOI: 10.4103/0019-557X.77266.
Vankar GK, Bhadania S, Parikh M. Stress and coping among resident doctors. 2011.
Dyrbye L, Shanafelt T. A narrative review on burnout experienced by medical students and residents. Med Educ 2016;50(1):132–149. DOI: 10.1111/medu.12927. PMID: 26695473.
Wu F, Ireland M, Hafekost K, et al. National mental health survey of doctors and medical students. Melbourne, Victoria: Beyond Blue; 2013.
Naji L, Singh B, Shah A, et al. Global prevalence of burnout among postgraduate medical trainees: a systematic review and meta-regression. CMAJ Open 2021;9(1):E189–E200. DOI: 10.9778/cmajo.20200068.
Alexander D, Monk JS, Jonas AP. Occupational stress, personal strain, and coping among residents and faculty members. J Med Educ 1985;60(11):830–839. DOI: 10.1097/00001888-198511000-00002.
Butterfield PS. The stress of residency. A review of the literature. Arch Med 1988;148(6):1428–1435. PMID: 3288162.
Hsu K, Marshall V. Prevalence of depression and distress in a large sample of Canadian residents, interns, and fellows. Am J Psych 1987;144(12):1561–1566. DOI: 10.1176/ajp.144.12.1561.
Navines R, Olive V, Ariz J, et al. Stress and burnout during the first year of residence training in a university teaching hospital: preliminary date. Dual Diagn Open Acc 2016;1:17. DOI: 10.21767/2472-5048.100017.
Saini N, Agrawal S, Bhasin S, et al. Prevalence of stress among resident doctors working in Medical Colleges of Delhi. Indian J Public Health 2011;54(4):219. DOI: 10.4103/0019-557X.77266.
Phitayakorn R, Minehart RD, Hemingway MW, et al. Relationship between physiologic and psychological measures of autonomic activation in operating room teams during a simulated airway emergency. Am J Surg 2015;209(1):86–92. DOI: 10.1016/j.amjsurg.2014.08.036.
Selye H. The stress of my life: a scientist's memoirs. 2nd ed. New York, USA: Van Nostrand Reinhold; 1979.
Bittner JGt, Khan Z, Babu M, et al. Stress, burnout, and maladaptive coping: strategies for surgeon well-being. Bull Am Coll Surg 2011;96(8):17–22. PMID: 22319907.
Shanafelt TD, Bradley KA, Wipf JE, et al. Burnout and self-reported patient care in an internal medicine residency program. Ann Intern Med 2002;136(5):358–367. DOI: 10.7326/0003-4819-136-5-200203050-00008.
Gan Y, Shang J, Zhang Y. Coping flexibility and locus of control as predictors of burnout among Chinese college students. Soc Behav Pers 2007;35(8):1087–1098. DOI: 10.2224/sbp.2007.35.8.1087.
Fresco DM, Williams NL, Nugent NR. Flexibility and negative affect: examining the associations of explanatory flexibility and coping flexibility to each other and to depression and anxiety. Cogn Ther Res. 2006;30(2): 201–210. DOI: 10.1007/s10608-015-9702-8.
Goldberg DP, Hillier VF. A scaled version of the General Health Questionnaire. Psychol Med 1979;9(1):139–145. DOI: 10.1017/s0033291700021644.
Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav 1983;24(4):385–396. PMID: 6668417.
Kristensen TS, Borritz M, Villadsen E, et al. The Copenhagen Burnout Inventory: a new tool for the assessment of burnout. Work Stress 2005;19(3):192–207. DOI: 10.1080/02678370500297720.
Winwood PC, Winefield AH. Comparing two measures of burnout among dentists in Australia. Int J Stress Manag 2004;11(3):282–289. DOI: 10.1037/1072-5245.11.3.282.
Carver CS, Scheier MF, Weintraub JK. Assessing coping strategies: a theoretically based approach. J Pers Soc Psychol 1989;56(2):267–283. DOI: 10.1037//0022-35220.127.116.117.
Fernando BMS, Samaranayake DL. Burnout among postgraduate doctors in Colombo: prevalence, associated factors and association with self-reported patient care. BMC Med Educ 2019;19(1):373. Available from: https://doi.org/10.1186/s12909-019-1810-9
Datar MC, Shetty JV, Naphade NM. Stress and coping styles in postgraduate medical students: a medical college-based study. Indian J Soc Psychiatry 2017;33(4):370–374. DOI: 10.4103/ijsp.ijsp_59_16.
Moffat KJ, McConnachie A, Ross S, et al. First-year medical student stress and coping in a problem-based learning medical curriculum. Med Educ 2004;38(5):482–491. DOI: 10.1046/j.1365-2929.2004.01814.x.
Goel N, Khandelwal V, Pandya K, et al. Alcohol and tobacco use among undergraduate and postgraduate medical students in India: a multicentric cross-sectional study. Cent Asian J Glob Health 2015;4(1):187. DOI: 10.5195/cajgh.2015.187.
Kasi PM, Khawar T, Khan FH, et al. Studying the association between postgraduate trainees’ work hours, stress and the use of maladaptive coping strategies. J Ayub Med Coll Abbottabad 2007;19(3):37–41. PMID: 18444589.