Developmental Processes of Residency Education

For many years the subject of the effects of stress on the emotional well-being of physicians and medical students was shrouded in a so-called conspiracy of silence. 1 Recently, however, this issue has been addressed more openly in attempts to improve the quality of residents' personal and professional lives. Rosenberg and Silver described personality changes experienced by medical students as a likely consequence of verbal and emotional abuses suffered during the training process. An internship has been likened to an adolescent hazing ritual, an endurance test that must be passed before being accepted into the larger fraternal order of 'real' doctors. Duffy described the medical education process as prolonging the 'state of adolescence with its problems of insecurity, striving competitiveness, and interpersonal difficulties with peers and superiors.' A healthy adaptation to the many inherent stresses of residency is critical to the individual's future medical career and emotional well-being.'