Letters

Stress among doctors

BMJ 1995; 310 doi: https://doi.org/10.1136/bmj.310.6981.742b (Published 18 March 1995) Cite this as: BMJ 1995;310:742
  1. Lorrie Symons,
  2. Rajendra Persaud
  1. Senior house officer Consultant psychiatrist Warlingham Park Hospital, Warlingham, Surrey CR6 9YR

    EDITOR,—Having been directly involved in the mental health care of other doctors, we have seen at first hand the high levels of stress and sheer misery among doctors.1 2 We are concerned, however, that the explanations produced for these findings tend to focus the blame on factors external to the profession, such as working conditions, junior doctors' hours, and the need for more career counselling. Yet our experience suggests that all ranks of the profession fail to discuss stress with colleagues, while peers prefer to ignore obvious symptoms of distress in others.3 This combination plus the tendency to soldier on explains the late and often emergency interventions that characterise the current state of doctors' mental health care.

    Of course, we could blame this on the under-funding of the NHS: lack of provision for doctors' sick leave ensures that people “going off sick” place an extra burden on already overworked colleagues, which produces a strong incentive to soldier on. Yet what the research has yet to do is to probe more uncomfortable questions—for example, how the psychology of the type of person attracted to a career in medicine might not be most conducive to owning up to times of personal vulnerability. This is important, as the theory that doctors' stress results from their working conditions ignores the issue of why some cope while others do not.

    The little research into this fascinating subject has already uncovered that childhood experiences of ill health may explain why some of us (whose parents were not doctors) are attracted to medicine.4 Research into why we should want to do this difficult and often poorly rewarded work needs further elaboration. After all, the most stressful aspect of any profession is to discover, after many years' training, that the way in which one's time is spent bears little relation to one's hopes and expectations.

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