title: Is Canadian surgical residency training stressful?
abstract: BACKGROUND
  Surgical residency has the reputation of being arduous and stressful. We sought to determine the stress levels of surgical residents, the major causes of stress and the coping mechanisms used.
  
  
  METHODS
  We developed and distributed a survey among surgical residents across Canada.
  
  
  RESULTS
  A total of 169 participants responded: 97 (57%) male and 72 (43%) female graduates of Canadian (83%) or foreign (17%) medical schools. In all, 87% reported most of the past year of residency as somewhat stressful to extremely stressful, with time pressure (90%) being the most important stressor, followed by number of working hours (83%), residency program (73%), working conditions (70%), caring for patients (63%) and financial situation (55%). Insufficient sleep and frequent call was the component of residency programs that was most commonly rated as highly stressful (31%). Common coping mechanisms included staying optimistic (86%), engaging in enjoyable activities (83%), consulting others (75%) and exercising (69%). Mental or emotional problems during residency were reported more often by women (p = 0.006), who were also more likely than men to seek help (p = 0.026), but men reported greater financial stress (p = 0.036). Foreign graduates reported greater stress related to working conditions (p < 0.001), residency program (p = 0.002), caring for family members (p = 0.006), discrimination (p < 0.001) and personal and family safety (p < 0.001) than Canadian graduates.
  
  
  CONCLUSIONS
  Time pressure and working hours were the most common stressors overall, and lack of sleep and call frequency were the most stressful components of the residency program. Female sex and graduating from a non-Canadian medical school increased the likelihood of reporting stress in certain areas of residency.
authors.affiliation: McMaster University, Hamilton, Ontario. aminazadeh@hotmail.com
authors.forename: Nasser
authors.initials: N
authors.lastname: Aminazadeh
authors.forename: Forough
authors.initials: F
authors.lastname: Farrokhyar
authors.forename: Amir
authors.initials: A
authors.lastname: Naeeni
authors.forename: Marjan
authors.initials: M
authors.lastname: Naeeni
authors.forename: Susan
authors.initials: S
authors.lastname: Reid
authors.forename: Arash
authors.initials: A
authors.lastname: Kashfi
authors.forename: Kamyar
authors.initials: K
authors.lastname: Kahnamoui
mesh_terms: D000328:Adult; D002170:Canada; D003430:Cross-Sectional Studies; D004503:Education, Medical, Graduate / Q000458:organization & administration; D005260:Female; D013502:General Surgery / Q000193:education; D006784:Hospitals, Teaching; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration*; D007588:Job Satisfaction; D008297:Male; D020380:Needs Assessment; D010549:Personal Satisfaction; D013315:Stress, Psychological / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D013997:Time Factors; D014940:Work Schedule Tolerance / Q000523:psychology*; D016526:Workload; D055815:Young Adult