The surgical resident whispered it under his breath, stepping away from the trauma bay. The blood on his gloves and scrubs, a dull reddish brown under fluorescent lights, told the story of a 12-hour shift spent fighting battles he often lost.
He was three years into residency, sleep-deprived, and far from home. Yet, for the first time, the weight of this young patient’s death made him pause. It wasn’t the first life he’d seen end, nor would it be the last.
But that day, as he scrubbed out, he realized: he’d started looking at his hands differently—not as tools of healing, but as instruments of a machine that never let him stop to grieve.
Medical training—while often hailed as noble and transformative—is fraught with exposure to trauma.
For aspiring doctors, the physical, emotional, and psychological toll of this experience can often go unaddressed, quietly accumulating like an untreated wound.
Medical training—while often hailed as noble and transformative—is fraught with exposure to trauma. For aspiring doctors, the physical, emotional, and psychological toll of this experience can often go unaddressed, quietly accumulating like an untreated wound.
The prevalence of trauma among medical trainees is significant, with research consistently highlighting high rates of emotional distress, burnout, and secondary traumatic stress.
Studies suggest that between 15-30% of residents experience symptoms of post-traumatic stress disorder (PTSD), often linked to repeated exposure to patient suffering, high-stakes decision-making, and loss of life.
Emotional exhaustion and depersonalization rates among trainee doctors often exceed 50%, indicating the pervasive toll of training environments that normalize high stress but lack adequate mental health support systems.
A cohort study involving 1,134 interns revealed that 56.4% reported experiencing trauma during their internship. Among those exposed to trauma, 19% screened positive for post-traumatic stress disorder (PTSD) by the end of their internship year.
| Specialty | PTSD Prevalence (%) |
|---|---|
| Emergency Medicine | 15.8 (Trauma exposure 72.4%) |
| Surgery | 22 (up to 40% for trauma surgeons) |
| Internal Medicine | 17.6 |
| Anesthesiology | 11.5 |
| Psychiatry | Higher during COVID-19 (exact % not specified) |
Factors such as age, sex, and working hours were associated with increased PTSD risk.
In medical training, not all specialties are created equal when it comes to exposure to trauma. Each specialty brings unique challenges, from acute losses to prolonged emotional investment.
Emergency Medicine
For the emergency physician-in-training, chaos is the baseline. Whether it’s resuscitating a child who has drowned or informing parents of a teenager’s fatal car accident, the trauma is acute and relentless. There’s no time to process; there’s always another ambulance pulling in, another life to save—or lose.
Surgery
Surgical residents walk a tightrope between precision and exhaustion. Their trauma is often procedural—repairing bullet wounds or excising tumors—but the emotional echoes of failed cases linger. Their “sterile field” often becomes an emotional barrier, as they compartmentalize grief to ensure their hands stay steady.
Pediatrics
The pediatric trainee faces a different form of anguish: the devastation of witnessing a child’s prolonged suffering or explaining terminal diagnoses to families. These experiences often erode the natural optimism many bring into the field.
Psychiatry
Those working with the mind are not immune to trauma. Psychiatry residents carry the heavy burden of knowing some patients might harm themselves despite intervention. Hearing patients’ own trauma stories in therapy or assessment can lead to secondary PTSD. Furthermore, 25% to 64% of psychiatry residents report aggression/violence; and 31% to 69% have had patients who have died by suicide.
Critical Care
Intensive care units often feel like theaters of high-stakes decision-making. For trainees, the act of balancing medical knowledge with emotional engagement in the face of multi-organ failure or prolonged life-support withdrawal can leave deep scars.
Hospital systems, steeped in hierarchy and tradition, often prioritize clinical outcomes over human well-being. But the cost of this neglect is evident in rising rates of depression, anxiety, substance use, and even suicide among healthcare providers.
Hospital systems, steeped in hierarchy and tradition, often prioritize clinical outcomes over human well-being. But the cost of this neglect is evident in rising rates of depression, anxiety, substance use, and even suicide among healthcare providers.
Despite the widespread acknowledgment of burnout, medical training systems rarely address trauma as a distinct phenomenon. This neglect creates a culture where emotional resilience is expected but rarely taught or supported.
Many trainees develop unhealthy coping mechanisms: denial, overwork, or detachment. Addiction, too.
Despite the high prevalence of trauma exposure, only about 27% of family medicine residency programs reported including education on trauma-informed care (TIC) in their curriculum. Of those, most dedicated five hours or less per year to this training.
This indicates a significant gap in preparedness among future physicians to handle trauma-related issues effectively.
The prevalence of trauma among medical trainees is significant, with research consistently highlighting high rates of emotional distress, burnout, and secondary traumatic stress.
Rates of PTSD are higher than the general public, and the cause is primarily exposure to trauma at work. We have to do something about this.
In the next article we will explore solutions.
