From medical student to junior doctor : maintaining good health during the “baptism of fire”

Emotional and psychological health

Medical students as a group are susceptible to a particular range of health problems, including depression and substance misuse. This may be partly a result of the prevailing culture of medical schools (box 1). The social climate engendered by this culture has traditionally normalised heavy alcohol use for male students.1 More recently, women students have begun to develop this pattern of drinking behaviour. Recreational drug use among medical students is less well studied, but it is known that drug use among university students is not uncommon, and this probably applies to medical students as well.2

The selection process for medical school may favour individuals with perfectionist, obsessive-compulsive, self critical, and altruistic traits, all of which predispose to vulnerability to psychological illness. Psychiatric morbidity, particularly depression, has been found in up to one in three senior medical students.34

Although this background of pre-existing vulnerability needs to be acknowledged, the main focus of this article is the impact on health of the considerable occupational stressors experienced by junior doctors. Historically, this “baptism of …