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Research Christmas 2019: Shiny Happy People

Political events and mood among young physicians: a prospective cohort study

BMJ 2019; 367 doi: (Published 09 December 2019) Cite this as: BMJ 2019;367:l6322
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A visual representation of the mood of medical interns over three years, showing the impact of political and non-political events

Linked Opinion

Is there a place for politics in medicine?

  1. Elena Frank, study director1,
  2. Brahmajee K Nallamothu, professor2,
  3. Zhuo Zhao, lead statistician3,
  4. Srijan Sen, associate professor4
  1. 1Molecular and Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, MI, USA
  2. 2Michigan Integrated Center for Health Analytics and Medical Prediction and Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
  3. 3Molecular and Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, MI, USA
  4. 4Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
  1. Correspondence to
    S Sen srijan{at} (or @srijan_sen_lab on Twitter)
  2. Accepted 10 October 2019


Objective To study the effects of recent political events on mood among young physicians.

Design Prospective cohort study.

Setting United States medical centres.

Participants 2345 medical interns provided longitudinal mood data as part of the Intern Health Study between 2016 and 2018.

Main outcome measures Mean mood score during the week following influential political and non-political events as compared with mean mood during the preceding four week control period.

Results We identified nine political events and eight non-political events for analysis. With the start of internship duties in July, the mean decline in mood for interns was −0.30 (95% confidence interval −0.33 to −0.27, t=−17.45, P<0.001). The decline in mood was of similar magnitude following the 2016 presidential election (mean mood change −0.32, 95% confidence interval −0.45 to −0.19, t=−4.73, P<0.001) and subsequent inauguration (mean mood change −0.25, 95% confidence interval −0.37 to −0.12, t=−3.93, P<0.001). Further, compared with men, women reported greater mood declines after both the 2016 election (mean gender difference 0.31, 95% confidence interval 0.05 to 0.58, t=2.33, P=0.02) and the inauguration (mean gender difference 0.25, 95% confidence interval 0.01 to 0.49, t=2.05, P=0.04). Overall, there were statistically significant changes in mood following 66.7% (6/9) of political events assessed. In contrast, none of the non-political events included in the analysis were statistically significantly associated with a change in mood.

Conclusions Macro level factors such as politics may be correlated with the mood of young doctors. This finding signals the need for further evaluation of the consequences of increasing entanglement between politics and medicine moving forward for young physicians and their patients.


  • We thank the physicians who took part in the study. We also thank Dr John Ayanian for his valuable insights.

  • Contributors: This study was designed by EF and SS. EF managed data collection. ZZ conducted the statistical analyses. EF, BN, and SS were responsible for interpreting the data. EF and SS wrote the initial manuscript draft, and BN provided critical revisions. SS obtained funding. All authors approved the final manuscript and had full access to the data. The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted. EF and SS are the guarantors.

  • Funding: Data collection for this study was funded by the National Institute of Mental Health (R01MH101459) and the American Foundation for Suicide Prevention (LSRG-0-059-16). The sponsors had no involvement in the study design, collection, analysis, or interpretation of data or writing of the manuscript. The content of this study is solely the responsibility of the authors and does not necessarily represent the official views of the sponsors.

  • Competing interests: All authors have completed the ICMJE uniform disclosure form at and declare: no support from any organisation for the submitted work; BN reports grants from the American Heart Association, Apple, Inc., and Toyota, compensation as Editor-in-Chief of Circulation: Cardiovascular Quality and Outcomes, a journal of the American Heart Association, and possession of ownership shares of AngioInsight, Inc. outside the submitted work. The authors report no other relationships or activities that could appear to have influenced the submitted work.

  • Ethical approval: This study was approved by the University of Michigan Medical School Institutional Review Board (HUM00033029).

  • Data sharing: Dataset available from the corresponding author at

  • Transparency: The manuscripts guarantors (EF, SS) affirm that this manuscript is an honest, accurate, and transparent account of the study being reported; that no important aspects of the study have been omitted; and that any discrepancies from the study have been explained.

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