title: Show what you know and deal with stress yourself: a qualitative interview study of medical interns' perceptions of stress and gender.
abstract: BACKGROUND
  Medical students report high stress levels and in particular, the clinical phase is a demanding one. The field of medicine is still described as having a patriarchal culture which favors aspects like a physicians' perceived certainty and rationalism. Also, the Effort-Recovery Model explains stress as coming from a discrepancy between job demands, job control, and perceived work potential. Gendered differences in stress are reported, but not much is known about medical interns' perceptions of how gender plays in relation to stress. The aim of this study is to explore how medical interns experience and cope with stress, as well as how they reflect on the gendered aspects of stress.
  
  
  METHODS
  In order to do this, we have performed a qualitative study. In 2010-2011, semi-structured qualitative interviews were conducted with seventeen medical interns across all three years of the Masters programme (6 male, 11 female) at a Dutch medical school. The interview guide is based on gender theory, the Effort-Recovery Model, and empirical literature. Transcribed interviews have been analyzed thematically.
  
  
  RESULTS
  First, stress mainly evolves from having to prove one's self and show off competencies and motivation ("Show What You Know…"). Second, interns seek own solutions for handling stress because it is not open for discussion (… "And Deal With Stress Yourself"). Patient encounters are a source of pride and satisfaction rather than a source of stress. But interns report having to present themselves as 'professional and self-confident', remaining silent about experiencing stress. Female students are perceived to have more stress and to study harder in order to live up to expectations.
  
  
  CONCLUSIONS
  The implicit message interns hear is to remain silent about insecurities and stress, and, in particular, female students might face disadvantages. Students who feel less able to manifest the 'masculine protest' may benefit from a culture that embraces more collaborative styles, such as having open conversation about stress.
authors.affiliation: Department of Medical Humanities, VU University Medical Centre, EMGO Institute for Health and Care Research, School of Medical Sciences, Amsterdam, The Netherlands. p.verdonk@vumc.nl.
authors.forename: Petra
authors.initials: P
authors.lastname: Verdonk
authors.forename: Viktoria
authors.initials: V
authors.lastname: Räntzsch
authors.forename: Remko
authors.initials: R
authors.lastname: de Vries
authors.forename: Inge
authors.initials: I
authors.lastname: Houkes
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001291:Attitude of Health Personnel; D005260:Female; D006801:Humans; D007396:Internship and Residency; D007407:Interviews as Topic; D008297:Male; D009784:Occupational Diseases / Q000209:etiology / Q000523:psychology; D036301:Qualitative Research; D012737:Sex Factors; D013315:Stress, Psychological / Q000209:etiology / Q000523:psychology*; D055815:Young Adult