title: Stress and wellbeing of junior doctors in Australia: a comparison with American doctors and population norms.
abstract: BACKGROUND
  Stress in doctors adversely affects decision-making, memory, information-recall and attention, thereby negatively impacting upon the provision of safe and high quality patient care. As such, stress in doctors has been subject to increasing scientific scrutiny and has amassed greater public awareness in recent years. The aims of this study are to describe stress levels and the psychological wellbeing of current junior medical officers (JMOs), and to compare this to their predecessors, American surgical residents and population norms.
  
  
  METHODS
  Post graduate years 1 & 2 doctors at a single metropolitan tertiary referral center were surveyed in 2009 and 2014 using two reliable and validated psychometric questionnaires, the Short Form-36 (SF36) and Perceived Stress Scale-14 (PSS14), with additional questions pertaining to demographics and training. The results were compared with published data from American general surgical residents and Australian age-matched population norms.
  
  
  RESULTS
  Mean stress levels were lower in 2014 (23 ± 7.2) than in 2009 (27.2 ± 7.6) (p = 0.017). The mean PSS-14 score was lower than that of American surgical residents, both before (26.8 ± 7.3, p = 0.003) and after (26.7 ± 8.2, p = 0.004) implementation of the safe working hour policies but higher than societal controls (p < 0.0001). Whilst JMOs in 2014 reported better overall mental health compared to those in 2009 (p = 0.02), they were significantly worse than the general population (p = 0.009). Multivariate analysis showed that JMOs were more likely to have a high PSS-14 score or to have a low mental health score if they reported higher career anxiety (p < 0.05).
  
  
  CONCLUSIONS
  Doctors are still at risk despite an improvement in their stress levels and overall mental health. They are less likely to be stressed and to have better mental health if they have less career-related anxiety. This has implications for the medical education and training of our junior doctors.
authors.affiliation: Department of Urology, Concord Repatriation General Hospital, Sydney, Australia. deanne.soares@gmail.com.
authors.forename: Deanne S
authors.initials: DS
authors.lastname: Soares
authors.affiliation: Department of Urology, Concord Repatriation General Hospital, Sydney, Australia.
authors.forename: Lewis
authors.initials: L
authors.lastname: Chan
mesh_terms: D000328:Adult; D001007:Anxiety / Q000209:etiology; D001315:Australia; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008505:Medical Staff, Hospital / Q000523:psychology*; D008603:Mental Health; D013315:Stress, Psychological / Q000209:etiology*; D011795:Surveys and Questionnaires; D014481:United States