Ann Intern Med. 1988 Jul 15;109(2):154-61. doi: 10.7326/0003-4819-109-2-154.
Graduate physicians face formidable developmental tasks during residency training as they prepare for their professional careers. Adapting to becoming a skilled physician involves assuming and mastering many professional responsibilities for the proper care of patients while taking on many personal obligations such as marriage, parenthood, and financial independence. Adaptation requires physicians to cope successfully with a series of stresses that have been divided into three categories: situational, professional, and personal stresses. Each category is reviewed and both general and specific recommendations are offered to reduce the level of stress. Normal and abnormal responses to the stresses of residency training are described, and guidelines are provided for recognizing the impaired resident early. Recommendations are made for managing the residency program and treating the resident, should he or she become impaired.
住院医师培训期间，即将毕业的医生在为职业生涯做准备时面临着艰巨的发展任务。要成为一名技术娴熟的医生，需要承担并掌握许多照顾患者的专业职责，同时还要履行许多个人义务，如结婚、为人父母和实现经济独立。适应过程要求医生成功应对一系列压力，这些压力可分为三类：情境压力、职业压力和个人压力。本文对每一类压力进行了审视，并给出了减轻压力程度的一般性和具体建议。文中描述了对住院医师培训压力的正常和异常反应，并提供了早期识别受损住院医师的指导方针。如果住院医师出现受损情况，文中还给出了管理住院医师培训项目和治疗该住院医师的建议。
