It took more than a decade for researchers to track the mental health of medical interns in their most stressful time of training. However, it has been found that things have gotten better now.
This research was published in the ‘Annals of Internal Medicine Journal’. But those first-year residents, or interns, still have a sizable risk of developing depression. And many who do still don’t seek help.
The jump in depression scored over the course of the first post-medical school year has gotten 25% smaller from 2007 to 2019, according to the study of nearly 17,000 new doctors led by a team from the University of Michigan Medical School.
To help understand potential drivers of the effect, the team explored individual and residency program factors previously shown to be linked to depression among training doctors. The study suggested, but can’t prove, that reduced work hours, slightly increased sleep, more feedback from supervisors and increased use of mental health care contributed to the change in depressive symptoms over time. Data from the participants showed significant changes in all of these measures.
The findings came from the Intern Health Study, which has used wearable activity trackers, mobile apps, surveys and genetic tests to study medical interns at hundreds of teaching hospitals.
In addition to tracking a group with a known high risk of depression, the study provided a way to study the effects of intense, prolonged stress more generally.
That’s why the new results could have impacted beyond medical training. Other stressful jobs and long-term stressful situations might also benefit from the increased attention to reducing depression-related stressors that the graduate medical education community has focused on in recent years.
“The Intern Health Study offers a unique dataset for us to study the trend of this population’s mental health over a long time span,” said Yu Fang, M.S.E., the study’s first author and a researcher at the Michigan Neuroscience Institute.
“The story we have learned from these data could help to make strategic plans in shaping a better medical internship experience in the future,” Fang added.
Srijan Sen, M.D., PhD, the leader of the Intern Health Study, said, “Given that depression rates are still very high, compared to the general population, we are hopeful that the drivers of improvement over the past 13 years can help guide areas to focus on to catalyse even more improvement going forward.”
Sen is director of the U-M Frances and Kenneth Eisenberg and Family Depression Center, and a professor in MNI and the Department of Psychiatry at Michigan Medicine.
The reduction in the size of the depression-score jump came despite the fact that interns in later years were more likely to have risk factors for depression, including a history of the condition.
The data showed that interns’ work hours dropped by 11 per cent over the 13-year period, sleep hours per day went up nearly 5 per cent, and the percentage of residents with current depression who were getting professional help went from 14 per cent to 38 per cent.
Over the course of the 13 years studied, female interns experienced a more pronounced reduction in the magnitude of depression symptom increases across the intern year, and they were much more likely to seek mental health care. The percentage of interns who were female also increased over the 13-year study period.
The same was true for interns in non-surgical fields compared with those pursuing training in surgery or another surgery-based speciality; the reduction in work hours was larger in non-surgical interns.
The study did not show any measurable difference between those whose intern year included the first months of the Covid-19 pandemic and those who trained before. Other research from the Intern Health Study is looking at the impacts of the pandemic, including one already-published study about interns taking part in the study in China.