Depression Among Incoming Ophthalmology Trainees

Early medical training affects the mental health of residents. New-onset depression during internship persists beyond training and affects attrition, career satisfaction, and physician suicide. This study investigated depression rates among interns entering ophthalmology training and the relationship to work-related factors.

Prospective, multicenter cohort study. Interns were recruited since 2015 and participated in longitudinal assessments before and during their internship. Exposures included time in residency (measured at 3, 6, 9, and 12 months of intern year), work hours, and sleep hours.

This study was conducted at several institutional academic tertiary care centers located within the United States.

A population-based sample of 98 ophthalmology residents from the Intern Health Study (IHS) from July 2015 to June 2023 who reported their status in ophthalmology residency were included in this study.

Validated measures of depression [Patient Health Questionnaire-9 (PHQ-9)] at preinternship and 3, 6, 9, and 12 months of residency before the start of dedicated ophthalmology training. Outcomes included the proportion of ophthalmology-entering interns with major depression (PHQ-9 score ≥ 10), changes in mean PHQ-9 scores, and the relationship between PHQ-9 scores and mean work and sleep hours.

Of the 98 ophthalmology-bound interns (41 [41.8%] with self-reported depression at any timepoint prior to enrollment) included in the study, 3 (3.1%) had major depression on baseline assessment (PHQ-9 ≥ 10). 32 (32.7%) experienced major depression during the internship period. Approximately one-quarter of interns experienced depression in the month prior to starting dedicated ophthalmology training (postgraduate year 2, PGY-2). Preinternship mean PHQ-9 score (2.7 [95% CI, 1.6-3.8]) was significantly less than scores at 3 months (5.9 [95% CI, 4.6-7.2]), 6 months (6.1 [95% CI, 4.6-7.6]), 9 months (5.6 [95% CI, 4.3-6.9]), and 12 months (6.0 [95% CI, 4.4-7.5]). History of depression was not significantly predictive of PHQ-9 scores (p = 0.66). Every additional hour of sleep was predictive of a 1.6-point decrease on the PHQ-9 (p < 0.001).

In this prospective multicenter study, there is a rise in depressive symptoms during internship, and these symptoms persist throughout the year. Nearly one-quarter of residents were depressed in the month prior to entering dedicated ophthalmology training (PGY-2). These findings highlight the need to address the mental health of early ophthalmology trainees.