Communication & Medicine, Vol 14, No 2 (2017)

Vulnerability of medical students and professionals to extreme work stress: A select review of the literature

Maciej Walkiewicz, Małgorzata Tartas
Issued Date: 27 Mar 2018


The goal of the paper is to describe the extent to which medical students and professionals are vulnerable to extreme stress. A select review of existing literature on this area has been undertaken, using the English-language online databases EBSCO, Medline and PubMed. The search has identified 36 citations relating to 6324 medical students and 28,285 medical staff (physicians, residents, nurses). The review indicates that merely beginning medical studies is a risk factor for stress, and that medical professionals, who are vulnerable to extreme work stress, say that they do not receive enough support from their co-workers. They are also often notably impulsive, introverted, neurotic and perfectionist, with low emotional intelligence and agreeableness, as well as low and external locus of control. Additionally, from longitudinal studies we have been able to identify psychological factors underpinning admission to a medical university that may be useful for predicting future stress in medical career. The results of this study may be taken into account when organizing psychological intervention programs targeted at educating future medical professionals. It seems that early identification of people at risk could reduce the impact of stress related to medical career and enhance the somatic and mental health of medical professionals.

Download Media

PDF (Price: £17.50 )

DOI: 10.1558/cam.31007


Bruce, S. M., Conaglen, H. M. and Conaglen, J. V. (2005) Burnout in physicians: A case for peer-support. Internal Medicine Journal 35 (5): 272–278.

Buddeberg-Fischer, B., Stamm, M., Buddeberg, C. and Klaghofer, R. (2010) Chronic stress experience in young physicians: Impact of person- and workplace-related factors. International Archives of Occupational and Environmental Health 83 (4): 373–379.

Chew-Graham, C. A., Rogers, A. and Yassin, N. (2003) ‘I wouldn’t want it on my CV or their records’: Medical students’ experiences of help-seeking for mental health problems. Medical Education 37 (10): 873–880.

Chou, L.-P., Li, C.-Y. and Hu, S. C. (2014) Job stress and burnout in hospital employees: Comparisons of different medical professions in a regional hospital in Taiwan. BMJ Open 4: e004185.

Deary, I. J. (1994) Need medical education be stressful? Medical Education 28 (1): 55–57.

Dewa, C. S., Loong, D., Bonato, S., Nguyen Xuan, T. and Jacobs, P. (2014) How does burnout affect physician productivity? A systematic literature review. BMC Health Services Research 14: 325.

Dunwoodie, D. A. and Auret, K. (2007) Psych­ological morbidity and burnout in palliative care doctors in Western Australia. Internal Medicine Journal 37 (10): 693–698.

Dyrbye, L. N., Thomas, M. R. and Shanafelt, T. D. (2005) Medical student distress: Causes, consequences, and proposed solutions. Mayo Clinic Proceedings 80 (12): 1613–1622.

Dyrbye, L. N., West, C. P., Satele, D., Boone, S., Tan, L., Sloan, J. and Shanafelt, T. D. (2014) Burnout among U.S. medical students, residents, and early career physicians relative to the general U.S. population. Academic Medicine 89 (3): 443–451.

Ekici, D. and Beder, A. (2014) The effects of workplace bullying on physicians and nurses. Australian Journal of Advanced Nursing 31 (4): 24–33.

Gong, Y. H., Han, T. G., Chen, W., Dib, H. H., Yang, G. A., Zhuang, R. S., Chen, Y., Tong, X., Yin, X. and Lu, Z. X. (2014) Prevalence of anxiety and depressive symptoms and related risk factors among physicians in China: A cross-sectional study. PLOS ONE 9 (7): e103242.

Henning, K., Ey, S. and Shaw, D. (1998) Perfec­tion­ism, the impostor phenomenon and psychological adjustment in medical, dental, nursing and pharmacy students. Medical Education 32 (5): 456–464.

Hudek-Knezevic, J., Maglica, B. K. and Krapic, N. (2011) Croatian Medical Journal 52 (4): 538–549.

Jasperse, M., Herst, P. and Dungey, G. (2014) Evaluating stress, burnout and job satisfaction in New Zealand radiation oncology departments. European Journal of Cancer Care 23 (1): 82–88.

Kovacs, M., Kovacs, E. and Hegedu, K. (2010) Emotion work and burnout: Cross-sectional study of nurses and physicians in Hungary. Croatian Medical Journal 51 (5): 432–442.

Losa Iglesias, M. E., Becerro de Bengoa Vallejo, R. and Salvadores Fuentes, P. (2010) The relationship between experiential avoidance and burnout syndrome in critical care nurses: A cross-sectional questionnaire survey. International Journal of Nursing Studies 47 (1): 30–37.

McManus, I. C., Keeling, A. and Paice, E. (2004) Stress, burnout and doctors’ attitudes to work are determined by personality and learning style: A twelve year longitudinal study of UK medical graduates. BMC Medicine 2: 29.

McManus, I. C., Powis, D. A., Wakeford, R., Ferguson, E., James, D. and Richards, P. (2005) Intellectual aptitude tests and A levels for selecting UK school leaver entrants for medical school. British Medical Journal 331 (7516): 555–559.

Meerten, M., Rost, F., Bland, J. and Garelick, A. I. (2014) Self-referrals to a doctors’ mental health service over 10 years. Occupational Medicine 64 (3): 172–176.

Meeusen, V., Van Dam, K., Brown-Mahoney, C., Van Zundert, A. and Knape, H. (2010) Burnout, psychosomatic symptoms and job satisfaction among Dutch nurse anaesthetists: A survey. Acta Anaesthesiologica Scandinavica 54 (5): 616–621.

Ogden, J. (2012) Health Psychology: A Textbook. Fifth edition. London: Open University Press.

Ozyurt, A., Hayran, O. and Sur, H. (2006) Predictors of burnout and job satisfaction among Turkish physicians. QJM – An International Journal of Medicine 99 (3): 161–169.

Panagopoulou, E., Montgomery, A. and Benos, A. (2006) Burnout in internal medicine physicians: Differences between residents and specialists. European Journal of Internal Medicine 17 (3): 195–200.

Paraschakis, A. and Michopoulos, I. (2013) Suicide in physicians: An overview. European Psychiatry 28 (1): 1.

Ripp, J., Babyatsky, M., Fallar, R., Bazari, H., Bellini, L., Kapadia, C., Katz, J., Pecker, M. and Korenstein, D. (2011) The incidence and predictors of job burnout in first-year internal medicine residents: A five-institution study. Academic Medicine 86 (10): 1304–1310.

Rossler, W. (2012) Stress, burnout, and job dissatisfaction in mental health workers. European Archives of Psychiatry and Clinical Neuroscience 262 (2): 65–69.

Schlitzkus, L. L., Vogt, K. N., Sullivan, M. E. and Schenarts, K. D. (2014) Workplace bullying of general surgery residents by nurses. Journal of Surgical Education 71 (6): e149–e154.

Shanafelt, T. D., Boone, S., Tan, L., Dyrbye, L. N., Sotile, W., Satele, D., West, C. P., Sloan, J. and Oreskovich, M. R. (2012) Burnout and satisfaction with work-life balance among US physicians relative to the general US population. Archives of Internal Medicine 172 (18): 1377–1385.

Schneiderman, N., Ironson, G. and Siegel, S. D. (2005) Stress and health: Psychological, behavioral, and biological determinants. Annual Review Of Clinical Psychology 1: 607–628.

Stern, M., Norman, S. and Komm, C. (1993) Medical students’ differential use of coping strategies as a function of stressor type, year of training, and gender. Behavioral Medicine 18 (4): 173–180.

Stewart, S. M., Betson, C., Lam, T. H., Marshall, I. B., Lee, P. W. H. and Wong, C. M. (1997) Predicting stress in first year medical students: A longitudinal study. Medical Education 31 (3): 163–168.

Tartas, M., Walkiewicz, M., Budzinski, W., Majkowicz, M. and Wojcikiewicz, K. (2014) The sense of coherence and styles of success in the medical career: A longitudinal study. BMC Medical Education 14: 254.

Tartas, M., Walkiewicz, M., Budzinski, W., Majkowicz, M., Wojcikiewicz, K. and Zdun-Ryzewska, A. (2016) The coping strategies during medical education predict style of success in medical career: A 10-year longitudinal study. BMC Medical Education 16: 186.

Tartas, M., Walkiewicz, M., Majkowicz, M. and Budzinski, W. (2011) Psychological factors determining success in a medical career: A 10-year longitudinal study. Medical Teacher 33 (3): e163–e172.

Walkiewicz, M., Tartas, M., Majkowicz, M. and Budzinski, W. (2012) Academic achievement, depression and anxiety during medical education predict the styles of success in a medical career: A 10-year longitudinal study. Medical Teacher 34 (9): e611–e619.

Wolf, T. M. (1994) Stress, coping and health – enhancing well-being during medical-school. Medical Education 28 (1): 8–17.

Wolkow, A., Ferguson, S., Aisbett, B. and Main, L. (2015) Effects of work-related sleep restriction on acute physiological and psychological stress responses and their interactions: A review among emergency service personnel. Inter­national Journal of Occupational Medicine and Environmental Health 28 (2): 183–208.

Zeidner, M., Hadar, D., Matthews, G. and Roberts, R. D. (2013) Personal factors related to compassion fatigue in health professionals. Anxiety Stress and Coping 26 (6): 595–609.


  • There are currently no refbacks.

Equinox Publishing Ltd - 415 The Workstation 15 Paternoster Row, Sheffield, S1 2BX United Kingdom
Telephone: +44 (0)114 221-0285 - Email: [email protected]

Privacy Policy