Medical students have dramatically increased symptoms of depression when going through their internships, according to a new study from University of Michigan researcher Srijan Sen, MD, PhD. Sen and his colleagues surveyed 740 interns before, during and after their internships. They found that the number of people with sufficient symptoms to qualify as depressed increased from 3.9 before starting their internship to 25.7, during the internship.

I’ve always been fascinated by the fact that interns are often called on to work 24 to 72 hours in a row (though they now have to get sleep breaks). I mean, my eyes start crossing after 8 to 10 hours on the job--so why in the heck did anybody ever think it was a good idea to put doctors in training though that kind of gauntlet? These people hold scalpels, and more or less have our lives in their hands. Yes, they’re supervised, but why would anyone encourage a culture that almost invites mistakes to be made?

Sen’s research bears out that the pressures of an internship certainly aren’t good for the doctors in training. Two of the factors most strongly associated with increased depressive symptoms were long work hours and having made medical mistakes.

Interestingly, Sen’s research also corroborates other studies showing that a genetic defect in a serotonin transport gene increases a person’s vulnerability to depression under the stressful circumstances of an internship.

“With effective interventions currently available to help prevent depression, the predictive factors identified in this study could allow at-risk interns to take steps before they start to have symptoms to lower their chances of developing depression,” Sen says. “This information may also be valuable to medical residency program directors as they seek to make their programs healthier, both for their medical trainees and the patients that they treat.”