Since the beginning of the coronavirus pandemic, there’s been a growing mental health crisis—and not just for COVID-19 patients. A recent Boston University study notes that depression rates have tripled since quarantine began last March. Still, that study misses one group that is getting hit especially hard: the medical residents who care for these patients.

What’s happening to them? Are they more vulnerable to depression during these especially challenging times?


Yes, says a research team led by Jason Siegel, a professor in the Division of Behavioral and Organizational Sciences (DBOS) at Claremont Graduate University (CGU).


Siegel’s team is involved in an ongoing research project in partnership with the Hospital Corporation of America (HCA). This organization operates some 186 hospitals and thousands of other care sites in the U.S. and abroad.


Siegel and his graduate student researchers are developing strategies that hospitals can use to minimize stress and depression for this hard-hit segment of doctors.


The Medical Profession’s Workhorses

Medical residents are one of the profession’s workhorses: They face long hours and grueling schedules that can deprive them of sleep, affect their diets, and limit normal healthy social interactions (ABC’s Grey’s Anatomy makes their situation seem far more glamorous than it really is).

“Before COVID-19, residents were already struggling,” Siegel explained. “They’re a very resilient group, but you can’t take them for granted, especially now. Taking better steps to ensure their health and well-being is beneficial not only for them, either. It’s obviously important because of their patients.”


What causes burnout among many medical residents?

In pre-pandemic times, Siegel noted that residents faced a broad slate of causes, including long work hours, limited levels of autonomy, a lack of certainty about the future, worries over school debt, and the perception that their personal needs should be put aside to care for others.

To work under those conditions was hard enough before, but now “during COVID-19, it’s become even harder, and they’re feeling even more worn down,” he said.


Siegel said that finding value and meaning in one’s work is a critical part of one’s sense of well-being. Without that, “burnout can lead to depression, and that depression can lead to even deeper depression. It’s also possible that residents will be less likely to seek help for themselves or go the extra mile for patients.”


So, the CGU team’s research highlights the plight of medical residents in these especially stressful times to show hospital systems how to take a more humane approach in supporting them. This research becomes especially crucial when it comes to schedules and the number of hours they’re logging—and helping residents keep their psychological capital as intact as possible.


A Team With Diverse Skills, Experience

The genesis of the project was a partnership between Gregory Guldner, a doctor and program director of Riverside Community Hospital/University of California Riverside, and DBOS graduate student Anne Brafford, who worked with Guldner on a project for one of Siegel’s classes.

Siegel credits their work together (which resulted in two previous smaller HCA contracts) for resulting in a new contract and partnership that has enlisted Siegel and his students (including Brafford). That team includes Gabrielle Riazi, Brendon Ellis, and Stephanie Ramirez. Without the initial work conducted by Guldner and Brafford and the support from HCA, Siegel said this project would not exist.


Brafford, a lawyer who authored a book about lawyers and well-being before enrolling at CGU, is about to write her dissertation. Ellis is close to beginning his dissertation work. Riazi is a second-year psychology doctoral student who’s also completing her MPH. And Ramirez is starting her second year in a dual public health and psychology master’s degree program and plans to go to medical school.


 “It’s never too soon to plunge into fieldwork. That’s what I tell all of my students,” Siegel said. “You shouldn’t have to wait until after graduation to conduct important, helpful work that’s going to improve someone’s life.”


Research results

The team surveyed medical residents (most from the U.S. with some participants from abroad) and received data from 366 respondents. The average age of survey participants was 31, and the survey looked at a range of factors that contribute to their sustained experiences of stress.

Some of these factors shouldn’t be surprising to anyone: Residents reported that an increased workload and work schedule directly translated into a much greater degree of burnout. The team’s current survey fits into a larger effort that is also recording levels of resident stress pre-pandemic.


Over time, Siegel said, the team plans to look at the differences in these sets of data and come up with a set of recommendations and wellness interventions that hospitals can use to protect their residents’ health. The team’s work also includes co-authoring a paper about their research results.


Create Impact Now Through The CGU Experience

All of the team’s work captures the essence of the CGU academic experience. At CGU, students work closely with leading faculty on a variety of meaningful research projects that help people and give them chances to publish in scholarly journals while they’re still in their programs.

Siegel said the team is pleased to be working on this with HCA, which “cares greatly not only about their patients but their medical professionals, too.”


“No one’s immune to stress, not even doctors,” he added. “It’s very critical to protect their well-being because it has widespread consequences. Not only does their ability to take care of themselves decline, but it can also impact the quality of the care that they’re providing, too.”

For more information, visit cgu.edu.


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