Table of contentsIntroductionResearch methodsInclusion criteriaResultsProgram #1Program #2DiscussionIntroductionIt is widely recognized that the first step The hardest part of becoming a practicing physician is residency. Throughout their residency, medical residents must learn to adapt to a lifestyle radically different from the one they know – an experience that puts interns through many trials and proves in many extremely difficult case. Say no to plagiarism. Get a custom essay on “Why Violent Video Games Should Not Be Banned”? Get the original essay In 2003, the Accreditation Council for Graduate Medical Education (ACGME) established a limitation on work hours and training, i.e. a maximum of 80 hours per week. In 2011, the regulations were revised again and the maximum duration of the duty period was limited to 16 hours. However, in 2017, the ACGME changed its Common Program Requirements policy and extended the service period from 16 hours to 24 hours. In Israel, resident doctors work an average of 26 consecutive hours per shift and often have to work without sleep. It is argued that this stems from the general perception that medical residents are younger and more capable of working in all circumstances, without any regard for their health and quality of life. In 2013, a petition was presented to the court by a residents' society against Clalit Health Services and the Israeli Medical Association regarding their employment conditions, which violate Israeli law on working hours and rest. In response, the court decided to modify the clause which takes into account the working conditions of resident doctors. The law now suggests that resident doctors should be allowed two hours of sleep during their shift if this possibility exists. Israeli resident doctors, for their part, claim that this possibility is non-existent due to the high demand for residency.3 It can be deduced from these results that the approach to the working conditions of resident doctors is rather shaky and that the possible implications are not serious enough. It appears that around 30% of young doctors show symptoms of depression, and this figure is constantly increasing. The other two main disorders that accompany depression are anxiety and burnout. Depressed residents are faced with admitting they have a mental disorder and seeking treatment, which is considered a taboo subject in the medical community. Affected residents are not seeking help because they believe it would jeopardize their careers. Unfortunately, the refusal of these residents to seek treatment, thanks to the combination of their extensive medical knowledge and their access to various medical means – including medications – contributed to suicide accounting for 4% of all physician deaths. . In light of these statistics, it can be assumed that this is a potentially dangerous situation that manages to expand every year, claiming many victims in its path. In order to tackle this problem and ultimately eradicate it, it must be taken more seriously by the medical community in particular, while integrating prevention programs in all hospitals and working to an environment where asking for help is not considered taboo. The research aims to study and understand the main causes behind the appearance of these disorders, as well as to prove three hypothesesmain: That working conditions in residence play a considerable role in the appearance of depression, anxiety and professional burnout; socio-economic status has little or no effect on the quality of life of resident doctors and their susceptibility to these mental disorders; the lack of prevention programs and the lack of willingness of residents to seek help will have a major impact on the quality of patient care and on physicians. relationships with patients as well as the long-term mental health of residents. An additional objective is to evaluate the effectiveness of two programs that work for prevention and optimization of the quality of life of resident doctors. Research MethodsTwo main questions are asked: "What are the causes of depression, anxiety and burnout among medical residents?" » and “How can we prevent the appearance of these disorders?” » The first step in finding a solution to a problem is to identify the cause. In this case, the question is what aspect of residency causes medical residents to develop depression, anxiety, and burnout. Having established the causes of the prevalence of these disorders among resident doctors, and in order to eliminate them, it is important to consider a program that aims to find an effective prevention method. Inclusion criteriaIn order to ensure that this research addresses the topic effectively, the literature used was chosen only if it met the following criteria: only articles dealing with medical residents suffering from depression, anxiety and burnout were chosen. The research methods used had to be based on questionnaires or observational studies with consenting resident doctors. The residents in question had to have no history of depression or anxiety before residency, and finally the articles had to be in English, Spanish or Hebrew. Results In this research, seven studies were used in order to identify the causes of the onset of depression or anxiety. depression, anxiety, and burnout among medical residents around the world: 1 from Nigeria, 3 from Mexico, 2 from the United States, and 1 from Japan. The methods for assessing depression, anxiety and burnout used by the research were: the Hamilton scale14 (HAM-D for depression and HAM-A for anxiety), the Maslach Burnout Inventory16, the Beck Depression Inventory scale12, the CES-D scale17, the IM-ITE test15, a questionnaire based on the DSM-IV and ICD-1011, the Zung self-assessment scale13 and the National Harvard Screening Day16. The main causes identified for the prevalence of depression, anxiety and burnout among medical residents worldwide are high job demands and long working hours, followed by changes in their sleep hours and their eating habits. . Other factors included overload of responsibilities, unequal distribution of work, lack of time to devote to studies, personal involvement with patients (mainly psychiatric residents), financial debt, aggressive behavior of doctors seniors and the lack of budget for health services (in developing countries). country).Due to the negative effect of these factors on their mental health, depressed residents commit six times more medical errors than their unaffected colleagues. Therapeutic decision-making and diagnosis have also been damaged by these factors, leading to a decline in the quality of patient care (resulting in many cases in patient mortality).and patient-doctor relationships). The personalities of these residents have also been deeply affected, making them more apathetic and cynical. These qualities manifest themselves in the way they approach patients, contributing to the decline in the quality of patient care. In many cases, resident doctors have gone so far as to contemplate suicide, and in some cases, they have followed through on this plan and committed suicide. In the majority of cases, it was found that women were more prone to developing these disorders. by 1st and 2nd year residents. Other factors contributing to susceptibility were specialization; Residents in psychiatry, anesthesiology and primary care were most likely to have symptoms, debt greater than $200,000 and a low government budget for health care11; mainly in developing countries like Nigeria. Marital status appears to have little or no effect, but in general, single residents are more likely to be susceptible. Although all research has established that there is a correlation between residency and the onset of these disorders, some have suggested that the symptoms of depression, anxiety, and burnout have not affected long-term residents. term, but rather disappeared after the first months. Nevertheless, the symptoms of depersonalization persisted and affected their personality, manifesting mainly as cynicism, a harsh attitude, and apathy. Two programs were evaluated to identify the most effective prevention methods. Program #1 Includes two main steps: a. The first stage focuses on an anonymous online survey that was distributed to participants. Of the 63 participants who carried out the screenings; 33% were referred to a counselor, 14% received a personal assessment, and 22% were referred to a psychologist or psychiatrist.b. Second, residents were invited to participate in a campaign including workshops on physician burnout, depression and suicide, as well as destigmatizing help-seeking. Two main challenges were identified: a. Few residents responded to the invitation to participateb. Even more worrying, different establishments refused to participate on the grounds that there was no possibility that they would have such problems in their establishments. Overall, this program has proven to be effective. The responses were positive and 1/3 of the departments invited them a second time. Program #2This program worked alongside psychologists and psychiatrists. The staff's main goal was to strengthen existing strengths that medical residents may have as well as help them develop resilience. Treatments and “booster sessions” were available throughout the program, as well as direct care and consultations and educational workshops focused on wellness. promotion.Overall, a high level of satisfaction has been reported by residents and directors, and the demand for this program is increasing each year.DiscussionIn light of the results mentioned above, it is safe to say that the The primary hypothesis of this trial that a direct correlation between residency and the occurrence of symptoms of depression, anxiety, and burnout among medical residents is certainly true. However, some studies suggest that these symptoms are only transient and will disappear once the first few months of adaptation are over and will no longer be present in the long term. Another assumption that these articles proved false was that gender would have little or no effect. effect on susceptibility to these.