From Medical Student to Medical Resident: Graduate Medical Education and Mental Health in the United States

Background

Residency selection is a long and cost-intensive process. During the fourth year of medical school in the United States, students apply to multiple residency programmes devoting significant money and time. Concurrently, residency directors and coordinators spend substantial resources recruiting and interviewing students for a limited number of slots. After interviews conclude, faculty members meet and rank all applicants according to programme fit and quality. Osteopathic students match to their respective residency programmes at the beginning of February while allopathic student match in the middle of March. Residency selection is a long and arduous process for both sides. New residents report to their programmes in June or July, complete orientation, and begin their first rotations.

First-year residents (interns) hit the ground running. Even during orientation, interns are signing medical orders and patients charts. They assume responsibility of continuity patients from recently graduated residents and make treatment decisions at the hospital. With a limited patient panel and under the watchful supervision of attending physicians, interns act like fully-functioning physicians. During the first three months of residency, incidences of depression can increase from 4% to 27% while suicidal ideation can increased nearly 400% (Sen et al., 2010).