The price of internship through COVID-19: 1st year physicians report substantial mental health symptoms during the pandemic

OBJECTIVES: To examine the prevalence of mental health symptoms among medical interns working for the first time as physicians in a large tertiary hospital in Israel during the 1st COVID year. METHODS: All interns who worked for at least 2 months during the 1st COVID year (March 2020–February 2021) at the Tel-Aviv Sourasky Medical Center (TASMC), a large tertiary general hospital in Israel were approached simultaneously during April–May 2021, and were requested to fill in an online survey. In each questionnaire, the interns were asked to refer to the worst time they endured the symptoms described. Included were all medical. Depression and anxiety symptoms, post-traumatic stress symptoms and Burnout measures were evaluated using validated questionnaires. Depressive/anxiety symptoms were defined as primary end measures. We assessed the association between depression and anxiety symptoms, and demographic, post-traumatic and burnout measures. RESULTS: 145 out of 188 interns completed the study (77% overall response rate). The mean age was 30.36 ± 2.97. Almost half the interns (47%) reported depression/anxiety symptoms. The high depression/anxiety group was characterized by a lower mean age (29.87 ± 2.93 vs. 30.92 ± 2.91, p = 0.041), higher post-traumatic symptoms (15.62 ± 13.32 vs. 3.63 ± 5.59, p < 0.0001) and higher scores in 2/3 burnout subscales - emotional exhaustion (5.09 ± 1.29 vs. 3.61 ± 1.38, p = 0.000001) and depersonalization (3.83 ± 1.71 vs. 2.94 ± 1.46, p = 0.002). 11.4% of interns in the full sample reported they used cannabis or alcohol as “self-medication”. CONCLUSIONS: medical interns serving for their first year as physicians during the COVID pandemic, developed mental symptoms in alarming numbers. The findings point to a crucial need to implement active interventions to protect these doctors, so that they can safely embark on their medical careers, specifically in times of global health crises.