ABSTRACT
Objective: To complete a systematic review of the literature addressing major depression in resident physicians. Methods: In 2013, the authors completed a systematic review of articles addressing major depression in physicians in United States residency programs. The following keywords were used: anxiety, stress, and mood, medical residents or interns, physician residents, graduate medical education, depression, stress or anxiety, and suicide. Results: The prevalence of depression in resident physicians is higher than that of the general population. Many sociodemographic and residency-associated factors have been studied in their relation to resident physician depression. Only physical health, an unhappy childhood, and stress at work were found to have association with depression, while the amount of call, lifestyle, age, income, and season of the year were not associated with depression. Other factors had an equivocal relationship. Depression in resident physicians is associated with medical errors, decreased ability to handle work-related stress, leaves of absence, discontinuation of medical training, disruption in personal lives, and suicide. Intervention with treatment for depression, using a low-cost, confidential, off-campus program, was successful. However, physicians may hesitate to seek treatment for mental illness because of the professional consequences, such as difficulty with medical licensing, hospital privileges, and malpractice insurance. Conclusions: Major depression is common in resident physicians in the United States. It has a negative impact on the lives of the doctors and the patients whom they treat. There appear to be effective ways of assisting residents with major depression available to training programs.