Psychiatric problems in young doctors

By Professor Dr. Azhar Md Zain, Dean of Faculty of Medicine & Health Science, University Putra Malaysia (UPM).

Doctors like other professions are also prone to stress and stress related behaviors. Occupational stress has been found to be the cause of psychosomatic symptoms in workers and what is to stop doctors from suffering the same symptoms?

Doctors start learning to live with stress early in life as they struggle for a place in medical school. But when medical training starts, it becomes another unforgettable jolt to the emotions for it is the beginning of a process that can change the medical student’s emotions, beliefs and even character.

The traumatic first visit to the anatomy dissecting room can be as early as the first week of medical studies. Most students may not have seen a corpse before. The sight can be repulsive especially to those who have had it easy coming from upper class families. This is the first instance they have to learn to develop strategies to cope with their emotions.

Then comes clinical training in a hospital, medical students come face-to-face with incurable disease and death in their youth. A student recently described her first experiences in the hospital as “disgusting and dirty”. Another student found it “revolting” that some patients are denied needed treatment because there is not enough money or equipment or that there is a long wait list. How do newly qualified doctors cope with the stress? I notice some distance themselves emotionally from patients by depersonalizing them. Instead of referring to the person needing attention, the staff may say, “there’s a broken leg in room 4”. This simple stress relieving technique may escape most people but is indicative of early signs of pathology if left unattended.

In medical schools we trained doctors to be scientists but for many the greater part of their work consists of talking to patients. Some young doctors feel unprepared for the emotion of doctor-patient relationships. One thing that we train them to do but perhaps not adequately is breaking bad news. Some have to do it daily for example those working with cancer and terminal patients. More reports are now evident that young doctors working in these areas suffer more mood disorders than their counterparts working in other fields. People in crisis often need to ventilate their anguish, and these young doctors are expected to listen. Dealing with anxious, frightened people can be so tiring that some doctors suffer burnout and fatigue. For MORE.