PTSD is high among internal medicine residents, especially in year 3

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Takeaway

  • A survey of 3 academic medical institutions in the Philadelphia, Pennsylvania area shows that many reported at least 1 clinically significant symptom of posttraumatic stress disorder (PTSD).
  • The most common trigger for PTSD was verbal or physical assault by patients, families, or colleagues.
  • The highest PTSD rates occurred during postgraduate year 3.

Why this matters

  • The study is the first multi-institution look at PTSD rates among internal medicine residents.
  • The higher PTSD levels in year 3 are likely explained by increased clinical exposure and workload.

Study design

  • This cross-sectional survey-based study identified 280 internal medicine residents.
  • 194 residents completed the questionnaire and PTSD checklist for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (PCL-5) survey.
  • Funding: None disclosed.

Key results

  • 55.2% residents showed at least 1 clinically significant symptom (PCL-5 symptom score >2) associated with the stressor.
  • Verbal/physical assault by patients, families, or colleagues associated with highest relative PTSD symptom trigger rates.
  • Highest PTSD rates occurred during postgraduate year 3 (P=.0005).
  • Death/harm of/to a colleague, verbal abuse (superior/colleague), and physical assault (patient/family) were least common stressors (events, 10.2%).
  • Common stressors included verbal abuse from patients/families (events,13.2%).

Limitations

  • Self-administered PCL-5 questionnaire.
  • Small numbers.

Coauthored with Chitra Ravi, MPharm