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Vance MC, Mash HBH, Ursano RJ, et al. Exposure to Workplace Trauma and Posttraumatic Stress Disorder Among Intern Physicians. JAMA Netw Open. 2021;4(6):e2112837doi: 10.1001/jamanetworkopen.2021.12837.
Vance, M. C., Mash, H. B. H., Ursano, R. J., Zhao, Z., Miller, J. T., Clarion, M. J. D., West, J. C., Morganstein, J. C., Iqbal, A., & Sen, S. (2021). Exposure to Workplace Trauma and Posttraumatic Stress Disorder Among Intern Physicians. JAMA network open, 4(6), e2112837. https://doi.org/10.1001/jamanetworkopen.2021.12837
Vance, Mary C, et al. "Exposure to Workplace Trauma and Posttraumatic Stress Disorder Among Intern Physicians." JAMA network open vol. 4,6 (2021): e2112837. doi: https://doi.org/10.1001/jamanetworkopen.2021.12837
Vance MC, Mash HBH, Ursano RJ, Zhao Z, Miller JT, Clarion MJD, West JC, Morganstein JC, Iqbal A, Sen S. Exposure to Workplace Trauma and Posttraumatic Stress Disorder Among Intern Physicians. JAMA Netw Open. 2021 Jun 01;4(6):e2112837. doi: 10.1001/jamanetworkopen.2021.12837. PMID: 34100937; PMCID: PMC8188264.
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JAMA Netw Open. 2021 Jun 01;4(6):e2112837. doi: 10.1001/jamanetworkopen.2021.12837.

Exposure to Workplace Trauma and Posttraumatic Stress Disorder Among Intern Physicians.

JAMA network open

Mary C Vance, Holly B Herberman Mash, Robert J Ursano, Zhuo Zhao, Jessica T Miller, Michael Jeremy D Clarion, James C West, Joshua C Morganstein, Abeer Iqbal, Srijan Sen

Affiliations

  1. Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University, Bethesda, Maryland.
  2. Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland.
  3. Michigan Neuroscience Institute, University of Michigan, Ann Arbor.
  4. F. Edward Herbert School of Medicine, Uniformed Services University, Bethesda, Maryland.

PMID: 34100937 PMCID: PMC8188264 DOI: 10.1001/jamanetworkopen.2021.12837

Abstract

IMPORTANCE: Physicians are exposed to traumatic events during their work, but the impact and outcomes of these exposures are understudied.

OBJECTIVE: To determine the prevalence and associations of work-related trauma exposure and posttraumatic stress disorder (PTSD) among a cohort of resident physicians in their internship year of training.

DESIGN, SETTING, AND PARTICIPANTS: This cohort study involved physicians entering internship at US residency programs nationwide in 2018. Participants completed a baseline survey 1 to 2 months before commencing internship, as well as follow-up surveys at 4 time points during internship. Statistical analysis was performed from April 2020 to January 2021.

EXPOSURES: Twelve months of internship.

MAIN OUTCOMES AND MEASURES: Prevalence of work-related trauma and prevalence of PTSD among those who experienced work-related trauma. Trauma exposure and PTSD symptoms were assessed using the Primary Care PTSD Screen for Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) (PC-PTSD-5). Risk factors assessed included depression, anxiety, early family environment, stressful life experiences, medical specialty, hours worked, and concern about medical errors.

RESULTS: Among 1134 interns who completed the PC-PTSD-5 at month 12 of internship, 665 (58.6%) were female and 695 (61.6%) were non-Hispanic White; the mean (SD) age was 27.52 (2.50) years. There were 640 interns (56.4%) who reported work-related trauma exposure; among these interns with trauma exposure, 123 (19.0%) screened positive for PTSD. Overall, 123 of 1134 training physicians (10.8%) screened positive for PTSD by the end of internship year, as compared with a 12-month PTSD prevalence rate of 3.6% in the general population. Multivariable logistic regression analyses, adjusting for demographic characteristics, indicated that risk factors associated with trauma exposure included non-Hispanic White race/ethnicity (odds ratio [OR], 1.51 [95% CI, 1.14-2.01]; P = .004), more hours worked (OR, 1.01 [95% CI, 1.00-1.03]; P = .03), early family environment (OR, 1.03 [95% CI, 1.01-1.05]; P < .001), and stressful life experiences at baseline (OR, 1.46 [95% CI, 1.06-2.01]; P = .02). Risk factors associated with PTSD were being unmarried (OR, 2.00 [95% CI, 1.07-3.73]; P = .03) and non-Hispanic White (OR, 1.77 [95% CI, 1.01-3.11]; P = .05), concern about medical errors (OR, 1.21 [95% CI, 1.00-1.46]; P = .05), stressful life experiences during internship (OR, 1.43 [95% CI, 1.14-1.81]; P = .002), depression at month 12 of internship (OR, 2.52 [95% CI = 1.36-4.65], P = .003), and anxiety at month 12 of internship (OR, 2.14, [95% CI, 1.13-4.04]; P = .02).

CONCLUSIONS AND RELEVANCE: This study found that work-related PTSD was 3 times more prevalent among intern physicians than the general population. These findings suggest that effective interventions to reduce trauma exposure and mitigate the effects of trauma are needed.

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