The Developmental Process of Residency Education

For many years the subject of the effects of stress on the emotional well-being of physicians and medical students was shrouded in a so-called conspiracy of silence.¹Recently, however, this issue has been addressed more openly in attempts to improve the quality of residents' personal and professional lives.²⁻⁵ Rosenberg and Silver⁶described personality changes experienced by medical students as a likely consequence of verbal and emotional abuses suffered during the training process. An internship has been likened to an adolescent hazing ritual,⁷an endurance test that must be passed before being accepted into the larger fraternal order of "real" doctors. Duffy⁸described the medical education process as prolonging the "state of adolescence with its problems of insecurity, striving competitiveness, and interpersonal difficulties with peers and superiors." A healthy adaptation to the many inherent stresses of residency is critical to the individual's future medical career and emotional well-being. Maladaptation to these