Beyond "the men of steel". The origins and significance of house staff training stress.

Stress is a common and significant component of house staff training. It has a dual capacity to support and hinder the trainee's education and well-being. However, there has been infrequent attention to the purpose and significance of training stress in the medical literature. The myths and traditions of medicine that foster sayings such as "in the days of the giants" or "the men of steel" do not sufficiently explain the dynamics of house staff stress. This article examines the origins, effects, and meaning of house officer stress. Stress seems to originate from as well as influence: the psychology of physicians, patient care, hospital economics, and the relationship between trainees and educators. Adaptations to stress acquired in training influence the house officer's future professional and personal well-being. Evaluation of training stress can help clarify related issues such as physician impairment and mentoring in medical education.