Depression Risk and Work Hours in Training Physicians Before and During the COVID-19 Pandemic

Area of Science:

• Medical Education
• Public Health
• Psychiatry

Background:

• The COVID-19 pandemic significantly impacted the general population's mental health.
• Training physicians experienced unprecedented changes in their work environments.
• The specific effects of these changes on physician mental health remained largely unknown.

Purpose of the Study:

• To investigate changes in depression risk among training physicians during the COVID-19 pandemic.
• To identify factors associated with depression risk in this population.

Main Methods:

• A prospective cohort study was conducted across U.S. and Shanghai healthcare institutions.
• First-year resident physicians (interns) were followed across academic years.
• Depressive symptoms (PHQ-9) and work hours were assessed quarterly.

Main Results:

• U.S. interns showed a decrease in depressive symptoms (11%) during the pandemic, mediated by reduced work hours.
• Depressive symptoms and work hours returned to pre-pandemic levels by fall 2020.
• A similar reduction in depressive symptoms was observed in Shanghai interns during a 2022 lockdown, also linked to work hours.

Conclusions:

• The COVID-19 pandemic was associated with a significant decrease in depressive symptoms among training physicians.
• Reduced work hours were a primary factor mediating this decrease.
• Understanding these associations can guide interventions to support physician well-being.