Fresán Ana, Guízar-Sánchez Diana, Yoldi-Negrete María, Robles-García Rebeca, Tovilla-Zárate Carlos-Alfonso, Saracco-Álvarez Ricardo
Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City, Mexico.
Departamento de Fisiología de la Facultad de Medicina, Universidad Nacional Autónoma de México, UNAM, Copilco Universidad, Mexico City, Mexico.
J Surg Educ. 2023 May;80(5):666-675. doi: 10.1016/j.jsurg.2023.01.013. Epub 2023 Feb 18.
Physicians in training face a variety of stressors throughout their professional development and according to their gender. Among them, surgical trainees appear to be especially at risk for mental health problems.
The aim of the present study was to compare demographic features, professional activities and adversities, depression, anxiety, and distress among men and women trainees of surgical and nonsurgical medical specialties.
A cross-sectional, retrospective, comparative study was conducted on a total of 12,424 trainees (68.7% nonsurgical and 31.3% surgical) from Mexico through an online survey. Demographic features, variables related to professional activities and adversities, depression, anxiety, and distress were evaluated through self-administered measures. Comparative analyses using the Cochran-Mantel-Haenszel test for categorical variables and multivariate analysis of variance including medical residency program and gender as fixed factors to test their interaction effect for continuous variables were used.
An important interaction between medical specialty and gender was found. Women trainees from surgical specialties report more frequent psychological and physical aggressions. Women from both specialties had higher distress, significant anxiety, and depression than men. Men from surgical specialties worked more hours per day.
Gender differences are evident in trainees for medical specialties, with a larger impact in surgical fields. Mistreatment of students is a pervasive behavior that affects society as a whole, and actions to improve learning and working environments in all medical specialties, but mostly in surgical fields, are urgently needed.
接受培训的医生在其职业发展过程中，根据性别会面临各种压力源。其中，外科实习生似乎尤其容易出现心理健康问题。
本研究的目的是比较外科和非外科医学专业男女实习生的人口统计学特征、专业活动和困境、抑郁、焦虑和痛苦程度。
通过在线调查对来自墨西哥的总共12424名实习生（68.7%为非外科专业，31.3%为外科专业）进行了一项横断面、回顾性比较研究。通过自我管理的测量方法评估人口统计学特征、与专业活动和困境相关的变量、抑郁、焦虑和痛苦程度。使用 Cochr an - Mantel - Haenszel检验对分类变量进行比较分析，并使用包括医学住院医师培训项目和性别作为固定因素的多变量方差分析来检验它们对连续变量的交互作用。
发现医学专业和性别之间存在重要的交互作用。外科专业的女实习生报告遭受心理和身体攻击的频率更高。两个专业的女性比男性有更高的痛苦程度、显著的焦虑和抑郁。外科专业的男性每天工作时间更长。
医学专业实习生中存在明显的性别差异，在外科领域影响更大。对学生的不当对待是一种普遍存在的行为，影响着整个社会，迫切需要采取行动改善所有医学专业，尤其是外科领域的学习和工作环境。
