Inside Doctoring: Stages and Outcomes in the Professional Development of Physicians

By Robert H. Coombs; D. Scott May et al. | Go to book overview

Stress During the Internship Year

Joel E. Dimsdale


INTRODUCTION

Generations of physicians have regarded the internship as a singularly stressful period in their medical training; nevertheless, the stresses of internship have been relatively ignored as compared with the intense focus on stresses encountered by the medical student. This silence regarding the tasks of internship, its stresses, and indeed its rational planning is an interesting phenomenon. In conducting a survey of standard medical history texts, I was unable to find a single reference to "interns" in the indices.1-5 In the existing literature about internship, stress is rarely addressed directly, although some writers have alleged that the internship is a time of severe exploitation filled with psychological stress, anxiety, depression, fears of incompetence, and exhaustion.6-13 This relative paucity of information about intern stress is striking because the internship is a time of major change.

The term "intern" itself is an interesting choice for this training period. According to the Oxford English Dictionary, an intern is an "inmate," one who is confined "within the limits of a country, district, or place."14 How different this is from the term "student" (derived from studeo, meaning to be eager), or "resident" (one who rests). If etymology has anything to offer in elucidating the fate of the intern, it would appear that the intern is a rather ambivalently esteemed person.

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I wish to thank the friends and colleagues who participated in this study for their candor and eloquence. I also acknowledge with appreciation Thomas P. Hackett and Kenneth Kauvar for their comments and criticism.

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