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Stress and Impairment during Residency Training: Strategies for Reduction, Identification, and Management
Abstract
Graduate physicians face formidable developmental tasks during residency training as they prepare for their professional careers. Adapting to becoming a skilled physician involves assuming and mastering many professional responsibilities for the proper care of patients while taking on many personal obligations such as marriage, parenthood, and financial independence. Adaptation requires physicians to cope successfully with a series of stresses that have been divided into three categories: situational, professional, and personal stresses. Each category is reviewed and both general and specific recommendations are offered to reduce the level of stress. Normal and abnormal responses to the stresses of residency training are described, and guidelines are provided for recognizing the impaired resident early. Recommendations are made for managing the residency program and treating the resident, should he or she become impaired.
Article and Author Information
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↵* This paper was developed for the Association of Program Directors in Internal Medicine by the Resident Services Committee: Richard D. Aach, MD, Chairman; Thomas G. Cooney, MD; Donald E. Girard, MD; David Grob, MD; Jack D. McCue, MD; Malcolm I. Page, MD; John D. Reinhard, MD; David B. Reuben, MD; and Jay W. Smith, MD. This paper was adopted by the Council of the Association of Program Directors in Internal Medicine on 29 February 1988. Presented 1 December 1987 at the Plenary Session of the meeting of the Association of Program Directors in Internal Medicine, Philadelphia, Pennsylvania.
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Request for Reprints: Dema Nesbitt, Association of Program Directors in Internal Medicine, 655 Fifteenth St., NW, Suite 425, Washington, DC, 20005.
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Current Author Addresses: Resident Services Committee: Association of Program Directors in Internal Medicine, Washington, D.C. 20005.
- © 1988 American College of Physicians
