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Cited by 413Healthcare professionals’ stress and burnoutEmpathy and Medical EducationInnovations in Medical Education

Variation of Mood and Empathy During Internship

Bellini, Lisa M.·2002·JAMA
DOI 10.1001/jama.287.23.3143
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Abstract

CONTEXT: Internship is a time of great transition, during which mood disturbances are common. However, variations in mood and empathy levels throughout the internship year have not been investigated. OBJECTIVE: To examine mood patterns and changes in empathy among internal medicine residents over the course of the internship year. DESIGN: Cohort study of interns involving completion of survey instruments at 4 points: time 1 (June 2000; Profile of Mood States [POMS] and Interpersonal Reactivity Index [IRI]), times 2 and 3 (November 2000 and February 2001; POMS), and time 4 (June 2001; POMS and IRI). SETTING: Internal medicine residency program at a university-based medical center. PARTICIPANTS: Sixty-one interns. MAIN OUTCOME MEASURES: Baseline scores of mood states and empathy; trends in mood states and empathy over the internship year. RESULTS: Response rates for time 1 were 98%; for time 2, 72%; for time 3, 79%; and for time 4, 79%. Results of the POMS revealed that physicians starting their internship exhibit less tension, depression, anger, fatigue, and confusion and have more vigor than general adult and college student populations (P<.001 for all). Results of the IRI showed better baseline scores for perspective taking (P<.001) and empathic concern (P =.007) and lower scores for personal distress (P<.001) among interns compared with norms. Five months into internship, however, POMS scores revealed significant increases in the depression-dejection (P<.001), anger-hostility (P<.001), and fatigue-inertia (P<.001) scales, as well as an increase in IRI personal distress level (P<.001). These increases corresponded with decreases in the POMS vigor-activity scores (P<.001) and IRI empathic concern measures (P =.005). Changes persisted throughout the internship period. CONCLUSIONS: We found that, in this sample, enthusiasm at the beginning of internship soon gave way to depression, anger, and fatigue. Future research should be aimed at determining whether these changes persist beyond internship.

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  • Empathy has been shown to decline over the course of medical training and the course of physicians' medical careers, suggesting that interventions to increase empathy might need to be repeated over time to be effective.

    “Unfortunately, empathy has been shown to decline over the course of medical training91–94 and the course of physicians’ medical careers,85 suggesting that interventions to increase empathy might need to be repeated over time to be effective.”

    From Reducing Racial Bias Among Health Care Providers: Lessons from Social-Cognitive Psychology (2007) · cites this paper as [91]

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Authors
Bellini, L. M.
Affiliations
University of Pennsylvania (US)
Corresponding author
Bellini, Lisa M.
ORCID
Bellini, Lisa M.
Venue
JAMA
Publisher
American Medical Association (AMA)
Published
2002-06-19
Volume
287
Issue
23
Pages
3143
ISSN
  • 0002-9955 (ISSN-L)
  • 0098-7484
DOI
10.1001/jama.287.23.3143
OpenAlex
W2053657600
Cited by
413
References
18
Citations by year
2026: 9 · 2025: 9 · 2024: 11 · 2023: 12 · 2022: 9 · 2021: 20 · 2020: 15 · 2019: 21 · 2018: 13 · 2017: 24 · 2016: 22 · 2015: 23 · 2014: 25 · 2013: 21 · 2012: 19
FWCI
29.43
Type
journal article
Language
en
Open access
closed
Locations
  • JAMA (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
  • Health Sciences › Medicine › Psychiatry and Mental health › Empathy and Medical Education
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
Keywords
medical interns, mood states, empathy, internal medicine residency, transition to residency, depression, anger, fatigue, personal distress, empathic concern, perspective taking, Profile of Mood States, Interpersonal Reactivity Index
MeSH terms
Adult, Affect, Empathy, Female, Humans, Internship and Residency, Male, Psychological Tests, Stress, Psychological, Students, Medical, Time Factors, Cohort Studies

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