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Cited by 314Healthcare professionals’ stress and burnoutEmpathy and Medical EducationInnovations in Medical Education

Mood Change and Empathy Decline Persist during Three Years of Internal Medicine Training

Bellini, Lisa M., Shea, Judy A.·2005·Academic Medicine
DOI 10.1097/00001888-200502000-00013
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Abstract

PURPOSE: To examine longitudinal changes in mood and empathy over the course of the internal medicine residency. METHOD: The authors conducted a cohort study of 61 residents who completed the Profile of Mood States (POMS) and the Interpersonal Reactivity Index (IRI) at six time points during their internal medicine residency at a university-based program. (POMS was administered five times, and IRI was administered six times.) The main outcomes measured were trends in mood disturbances and multiple domains of empathy over the three-year residency, and comparisons to norms. RESULTS: Response rates varied from Time 1 to Time 6 (98%, 72%, 79%, 79%, 94%, and 95%, respectively). Interns had better scores on four POMS subscales: Depression-Dejection (p = .0031), Anger-Hostility (p < .0001), Fatigue-Inertia (p < .0001), and Vigor-Activity (p < .0001) compared with later administrations, especially midinternship. By the end of residency all POMS scores were returning towards baseline (effects sizes in the .20 s), but only depression was no longer significantly different. IRI scores showed the decline in Empathic Concern remained over residency whereas Personal Distress peaked midinternship year but approached baseline at the end of residency. Compared with the general population, the graduating residents were less tense, depressed, and confused. Personal Distress was significantly lower than the norm group. CONCLUSIONS: Internal medicine residency presents challenges resulting in common mood disturbances. Although graduating residents appear to be better off than the population norms, some domains of their mood disturbances and empathy never fully recover from their internship year.

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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 [92]

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Authors
Bellini, L. M., & Shea, J. A.
Affiliations
University of Pennsylvania (US)
Corresponding author
Bellini, Lisa M.
ORCID
Venue
Academic Medicine
Publisher
Oxford University Press (OUP)
Published
2005-02
Volume
80
Issue
2
Pages
164-167
ISSN
1040-2446 (ISSN-L)
DOI
10.1097/00001888-200502000-00013
OpenAlex
W2043098578
Cited by
314
References
16
Citations by year
2026: 9 · 2025: 4 · 2024: 8 · 2023: 9 · 2022: 19 · 2021: 25 · 2020: 16 · 2019: 18 · 2018: 13 · 2017: 21 · 2016: 16 · 2015: 20 · 2014: 21 · 2013: 11 · 2012: 18
FWCI
27.26
Type
journal article
Language
en
Open access
closed
Locations
  • Academic Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • DigitalGeorgetown (Georgetown University Library) (submittedVersion)
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
internal medicine residency, mood disturbance, empathy, empathic concern, personal distress, depression, anger-hostility, tension, intern year, longitudinal change, medical residents
MeSH terms
Affect, Empathy, Humans, Internal Medicine, Internship and Residency, Longitudinal Studies, Pennsylvania, Physicians, Psychiatric Status Rating Scales, Stress, Psychological, Cohort Studies

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