Resident Stress Revisited: A Senior Pediatric Resident’s Point of View

Abstract

It has been 15 years since Dr Abraham Bergman1 wrote his poignant essay for Pediatrics on resident stress. In some ways, it seems little has changed in those 15 years in the area of resident stress. Many of the points raised in Dr Bergman’s article are still relevant today. However, pediatric residents have recently entered a new era in pediatric education and training led by the Accreditation Council for Graduate Medical Education (ACGME).2 The ACGME has established guidelines that limit the number of hours a pediatric resident can work per shift, as well as per week. The guidelines set new standards for “competencies” in which residents should be trained as well as new ways that administrators must track and evaluate residents’ progress. The ACGME expects full compliance with these guidelines beginning July 1, 2003. As residents look forward with anticipation and hope to what changes these new guidelines will bring, it seems an appropriate time to revisit Dr Bergman’s article and evaluate the past and current sources of resident stress. This commentary will consider which sources of stress described by Dr Bergman are still relevant today, and whether the advent of the ACGME guidelines will alleviate any of these stressors for tomorrow’s pediatric house officer. Global causes of resident stress, as Dr Bergman explains, include the developmental milestones that pediatric residents must face as adults learning to balance their personal and professional lives. Dr Bergman lists the development of autonomy, individuation from one’s parents, and wrestling with financial independence as global causes of resident stress. These stressors are much the same today, as every new physician must struggle with his/her new role and new identity of being a physician. The development of financial independence continues to be a large source of stress for today’s debt-laden residents. The Future … Address correspondence to Megan A. Moreno, MD, University of Wisconsin-Madison, 3009 Stevens St, Madison, WI 53705. E-mail: ma.moreno{at}hosp.wisc.edu