Prevalence of stress in junior doctors during their internship training: a cross-sectional study of three Saudi medical colleges’ hospitals

Abstract

Hamza Mohammad Abdulghani,1 Mohammad Irshad,1 Mohammed A Al Zunitan,1,2 Ali A Al Sulihem,1,2 Muhammed A Al Dehaim,1,2 Waleed A Al Esefir,1,2 Abdulaziz M Al Rabiah,1,2 Rashid N Kameshki,1,2 Nourah Abdullah Alrowais,2 Abdulaziz Sebiany,3 Shafiul Haque1 1Department of Medical Education, College of Medicine, King Saud University, Riyadh, Saudi Arabia; 2Department of Family and Community Medicine, King Saud University, Riyadh, Saudi Arabia; 3Department of Family and Community Medicine, University of  Dammam, Dammam, Saudi Arabia Background: Medical science is perceived as a stressful educational career, and medical students experience monstrous stress during their undergraduate studies, internship, and residency training, which affects their cognitive function, practical life, and patient care. In the present study, an assessment of the prevalence of self-perceived stress among new medical graduates during their internship training has been performed, and correlations of self-perceived stress with sex, marital status, and clinical rotations have been evaluated.Patients and methods: Interns of the King Khalid, King Abdulaziz, and King Fahd University hospitals in Saudi Arabia were invited to complete a stress inventory known as the Kessler 10, which is used for stress measurement. Apart from stress evaluation, the questionnaire collected personal data, such as age, sex, and marital status, in addition to information relevant to hospital training, assigned duties, and clinical training rotations.Results: Our results showed that nearly 73.0% of interns were under stressed conditions. Most of the interns were affected by a severe level of stress (34.9%), followed by mild (19.3%) and moderate (18.8%) levels of stress. The stress level was significantly higher (84.0%) among female interns in comparison with male interns (66.5%) (odds ratio =2.64; confidence interval =1.59–4.39; P<0.0002). There were statistically significant differences between the percentages of male and female interns (P≤0.047) at mild, moderate, and severe stress levels. Marital status had no role in causing stress. The highest stress level was reported by interns during the clinical rotations of medicine (78.8%), followed by surgery (74.7%), pediatrics (72.4%), obstetrics and gynecology (70.1%), and emergency (58.3%). The prevalence of stress among the interns and their corresponding clinical rotations in all three hospitals had significant linear correlations (r≥0.829, P≤0.041). Conclusion: We found a significantly high level of stress among the medical interns. High stress may have negative effects on cognitive functioning, learning, and patient care. Hence, medical interns need support and subsequent interventions to cope with stress. Keywords: medical education, clinical rotation, medicine, surgery, pediatrics