The DOI matches its Crossref record.
The Stress of Residency: A Review of the Literature
Abstract
• A review of empiric studies of the stresses of residency training and descriptions of intervention programs and mental health resource surveys published since 1980 indicated that inadequate sleep and fatigue are major stressors for residents, but they are only part of a more complex situation influenced by time demands, social support, and maturational factors. Other important stressful aspects of training appear to be those that interfere with social support. Increased anger, not depression, is emerging as the predominant mood change during residency, but the effects of any mood change on patient care have not been studied. Despite growing evidence of the need for change in training programs, especially attention to the affiliative needs of residents, few intervention programs have been reported. (Arch Intern Med1988;148:1428-1435)
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“It is a time of high stress (Butterfield, 1988)”
From Chronic Stress, Hair Cortisol and Depression: A Prospective and Longitudinal Study of Medical Internship (2018) · cites this paper as Butterfield, 1988
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Items 101–119 of 119
Ross, J. M., Watson, N. L., Hamlin, N. J., & Schmidt, J. E. (2024) · Military Medicine · doi:10.1093/milmed/usae270 · Cited by 2
Stress management: Corpus-based insights into vernacular interpretations of stress
Stvan, L. S. (2014) · Communication & Medicine · doi:10.1558/cam.v10i1.81 · Cited by 2
“A number of studies specifically focus on stress created within medical school training (Butterfield 1988; Shapiro et al. 2000; Radcliffe and Lester 2003). most literature involving the word stress, however, simply assumes one of the definitions.”
BackgroundPsychiatry Residents’ Attitudes Toward Personal Involvement in Research
Mulderig, J. K., Sansone, R. A., & Fine, M. A. (1992) · Academic Psychiatry · doi:10.1007/bf03341375 · Cited by 2
Miller, S. F. (1992) · The American Journal of Surgery · doi:10.1016/s0002-9610(05)80908-0 · Cited by 2
The clinical psychologist as program consultant: When is enough enough?
Sheridan, K. (1995) · Journal of Clinical Psychology in Medical Settings · doi:10.1007/bf01990883 · Cited by 2
“Studies on sources of residency stress are the most common and represent both theory (Hoekelman, 1989) and quantitative data ( Butterfield, 1988; Lee, 1987) to support conclusions.”
BackgroundMethodStress and the anesthesiologist
Gilbert, M. (1993) · Acta Anaesthesiologica Scandinavica · doi:10.1111/j.1399-6576.1993.tb03660.x · Cited by 2
Slonim, T.-Y., SLONIM, M. A., Daychman, G., et al. (2002) · Computers in cardiology · doi:10.1109/cic.1997.647911 · Cited by 1
Chen, C., Cheng, Y.-H., Shen, Y., Kung, C., Chien, P., & Hsieh, C. (2021) · Healthcare · doi:10.3390/healthcare9070912 · Cited by 1
“Inappropriate emotional stress can also impact the bedside skills of health workers [31,32].”
BackgroundRuzycki, S. M., Ordons, A. R. D., Davis, M., Steele, J. M., Osei-Tutu, K. B., & Welikovitch, L. (2024) · BMC Medical Education · doi:10.1186/s12909-024-06176-6 · Cited by 3
“Residency is a notoriously challenging time professionally and personally [1–3].”
BackgroundThe Impact of Residency Training on Physicians' Outlook on AIDS: A Cohort Analysis
Yedidia, M. J., & Berry, C. A. (1996) · Medical Care Research and Review · doi:10.1177/107755879605300205 · Cited by 1
Professional Stress During Medical Internship
Sultan, A. I. A., Parashar, S., Wahass, S. H., et al. (2002) · Qatar medical journal · doi:10.5339/qmj.2002.1.19 · Cited by 1
허유성, 전영진, Yoo, H., et al. (2015) · CNU Journal of Educational Studies · doi:10.18612/cnujes.2015.36.3.27
Job Satisfaction of Emergency Medicine Residents and Specialists in Iran: A Cross-Sectional Study
Seyedhosseini, J., Zaringhalam, M., Farahmand, S., et al. (2018) · Trauma Monthly · doi:10.5812/traumamon.55963
“In a review of stress in medical residents by Butterfield, sleep deprivation and fatigue were the most important factors inducing stress (14).”
BackgroundMedical Student and Resident Physician Marriages
Myers, M. F. (1994) · Springer eBooks · doi:10.1007/978-1-4899-1007-3_1
Is It All COVID-19? Resident Distress and Reasons for It in 2020
QURASHI, H. M. S., Atrash, A., & Asken, M. J. (2022) · Southern Medical Journal · doi:10.14423/smj.0000000000001401
“Despite the potential for personal and professional development, the refinement of unique skills, and opportunities to make lifelong friends and colleagues, for more than 30 years residency training has been recognized as a stressful experience.(1) Focusing on polar terms such as burnout and wellness, the contemporary…”
BackgroundImpact of short-term locum doctor employments on the transition from medical student to residency
Dam, L. A. P., Møller, J. E., Lou, S., Matthiesen, S. S., Thomsen, L. C. I., & Randsbæk, F. (2024) · Danish Medical Journal · doi:10.61409/a07230445 · Cited by 1
When the Physician Becomes a Patient
Gautam, M. (2025) · Springer eBooks · doi:10.1007/978-3-031-93533-6_52
Farzanegan, F., Shadi, E., Esmaily, H., et al. (2025) · Human Resources for Health · doi:10.1186/s12960-025-01039-7
“These studies collectively underscore that persistent stressors, such as workload, patient demands, and fear of litigation, remain [4, 9, 29, 30, 41, 42] consistently shows that postgraduate trainees experience higher stress compared with students or practicing dentists.”
Metadata
- Authors
- Butterfield, P. S.
- Corresponding author
- Butterfield, Paula S.
- Venue
- Archives of Internal Medicine
- Publisher
- American Medical Association (AMA)
- Published
- 1988-06-01
- Volume
- 148
- Issue
- 6
- Pages
- 1428
- ISSN
- 0003-9926 (ISSN-L)
- OpenAlex
- W4319704952
- Cited by
- 112
- References
- 0
- Citations by year
- 2025: 5 · 2024: 3 · 2022: 5 · 2021: 2 · 2019: 4 · 2018: 5 · 2017: 1 · 2016: 1 · 2015: 4 · 2014: 2 · 2013: 3 · 2012: 1
- FWCI
- 17.39
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Internal Medicine (publishedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
- Social Sciences › Education › Innovations in Medical Education
- Social Sciences › Psychology › Social Psychology › Stress and Burnout Research
- Keywords
- residency training, medical residents, occupational stress, sleep deprivation, fatigue, social support, anger, mood changes, mental health resources, intervention program, time requirements, training program reform
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