title: Stressful incidents, stress and coping strategies in the pre-registration house officer year.
abstract: BACKGROUND
  Previous studies have drawn attention to the stresses experienced by doctors in their first year.
  
  
  OBJECTIVE
  To gain a deeper understanding of the causes of stress in newly qualified doctors, how they cope, and what interventions might make the year less traumatic.
  
  
  METHODS
  Postal questionnaire. This study focused on an open question asking about a stressful incident, the coping strategy used to deal with it, stressors in general and current levels of stress using the General Health Questionnaire.
  
  
  METHODS
  336 hospitals throughout the United Kingdom.
  
  
  METHODS
  A cohort of doctors followed from the time of their application to medical school, studied towards the end of their pre-registration year (n=2456).
  
  
  RESULTS
  The response rate to the questionnaire was 58.4%. The incidents were categorised into the major groups Responsibility (33.6%), Interpersonal (29.7%), Overwork (17.0%), Death and disease (13.0%), and Self (6.7%). GHQ revealed psychological morbidity in 31% of respondents. Stress levels were highest in those reporting an incident about Responsibility or Self, lowest in those describing Death or disease. Stressors in general and preferred coping strategies differed between the groups.
  
  
  CONCLUSIONS
  The incidents suggested the following interventions to reduce stress: better supervision in the first few weeks in post, at night, and for medical problems on surgical wards; more attention to avoiding sleep deprivation; more time for discussion with colleagues at work; more personal time with friends and family. The choice of incident described was influenced by the personal characteristics of the respondent.
authors.affiliation: London Postgraduate Medical and Dental Education, UK. epaice@londondeanery.ac.uk
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Paice
authors.forename: Harry
authors.initials: H
authors.lastname: Rutter
authors.forename: Mike
authors.initials: M
authors.lastname: Wetherell
authors.forename: Belinda
authors.initials: B
authors.lastname: Winder
authors.forename: I C
authors.initials: IC
authors.lastname: McManus
mesh_terms: D000223:Adaptation, Psychological; D001007:Anxiety / Q000209:etiology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008505:Medical Staff, Hospital / Q000523:psychology*; D013315:Stress, Psychological / Q000209:etiology*; D011795:Surveys and Questionnaires; D006113:United Kingdom