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Updated: Aug 28, 2026

Assessment of Stress Effects on Cognitive Flexibility using an Operant Strategy Shifting Paradigm
Published on: May 4, 2020
Effect of Occupational Stress on Cognitive Functions Among Resident Doctors
Mohammad S Raza1, Farahanaz B Irani1, Pranita M Kadam1
1Physiology, Mahatma Gandhi Mission's (MGM) Medical College and Hospital, MGM Institute of Health Sciences, Aurangabad, IND.
Abstract:
Background Occupational stress is highly prevalent among postgraduate medical residents due to heavy workload, prolonged duty hours, emergency responsibilities, and sleep deprivation. Chronic stress may adversely affect cognitive functions, compromising both the physician's well-being and patient care. This study aimed to assess occupational stress among postgraduate resident doctors and evaluate its effect on cognitive functions. Methods A cross-sectional observational study was conducted in the Department of Physiology, Mahatma Gandhi Mission Medical College and Hospital, Aurangabad, Maharashtra, India, from April 2024 to March 2026. A total of 281 resident doctors aged 25-45 years were enrolled and categorized into clinical, para-clinical, and pre-clinical departments. Occupational stress was assessed using the Professional Psychological Stress Test based on the David Fontana protocol. Cognitive functions, including attention, perception, execution, and working memory, were evaluated using standardized computerized cognitive tests. Data were analyzed using Statistical Product and Service Solutions (SPSS, version 24; IBM SPSS Statistics for Windows, Armonk, NY). Quantitative variables were expressed as mean ± SD and categorical variables as proportions. Chi-square test, one-way ANOVA, unpaired t-test, and Pearson's correlation coefficient were used, with p < 0.05 considered statistically significant. Results A total of 281 resident doctors were enrolled, including 239 (85.1%) clinical, 31 (11.0%) para-clinical, and 11 (3.9%) pre-clinical residents. Moderate occupational stress was observed in 133 (47.3%) participants, while 126 (44.8%) experienced high stress, with significantly higher stress levels among clinical residents (p<0.00001). Clinical residents also had significantly longer working hours, more emergency duty calls, shorter sleep duration, and higher systolic and diastolic blood pressure than para-clinical and pre-clinical residents (all p<0.001). Cognitive assessment demonstrated significantly poorer attention, perception, and executive function among clinical residents (p<0.05), whereas working memory did not differ significantly across departments. In the clinical group, occupational stress showed significant positive correlations with impaired attention (r=0.172, p=0.008), executive function (r=0.249, p<0.0001), and working memory performance (r=0.340, p<0.0001), while no significant correlations were observed among para-clinical and pre-clinical residents. Conclusion Occupational stress is highly prevalent among postgraduate resident doctors, particularly in clinical specialties. Increased stress is associated with impaired cognitive functions, especially attention, executive function, and working memory. Heavy workload, sleep deprivation, unhealthy lifestyle habits, and elevated blood pressure further contribute to these adverse effects. Institutional stress-management strategies, promotion of healthy lifestyles, and mental health support are essential to improve resident well-being, cognitive performance, and quality of patient care.
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