Pyschological distress in doctors

In Malaysia, the Medical Act 1971 defines ‘Internship’ or ‘Housemanship’ as a period of structured supervised practical training for 2 years, in any Public health care institution, upon completing 5/6 years of medical degree programme in an accredited medical school. This training scheme is mandatory in order to birth professionalism and appropriate attitude amongst freshmen doctors, to better serve and provide health care services to the public (Tan et al., 2013). This training includes two years of service, comprising of six supervised postings for a minimum of four months, in the various allocated departments as per tallied by the Malaysian Medical Association. Successful completion of this housemanship programme requires specific documentation, including satisfactory reports from the supervisors and heads of each department, which indicates that the houseman is now eligible to be registered as a full-fledged doctor, and ready to serve in independent capacity in various public/private health sectors. Before crossing over to becoming a full-fledged doctor, what are all the circumstantiality and predicament a house officer has to go through in order to gain experience and skills to properly wear the title ‘Doctor’?
The number of medical graduates have been rising tremendously over the past few years, with the mushrooming of medical institutes all around the country, namely private medical institutions. The number of houseman is increasing year by year, and it is leading to a quantity versus quality scenario, and problems arise as the expectations from these fresh graduates increase, and the work distribution load gets more intense. When the coping ability of the fellow house officers does not tally with the pressure exerted upon him that is when Psychological distress comes in(Michie, 2002).
What is psychological distress? It represents a wide range of physical responses which occur as a direct effect of stressors which is causing an upset in the homeostasis of the human body. It can broadly be categorised into stress, anxiety and depression. Upon immediate abnormal changes of either psychological or physical balance, the body will respond by stimulating the nerves, hormones, and immune systems all together in a pronounced period of time.
Stress itself is not all that harmful as it is being perceived by the society. An optimal amount of stress is actually required in the field of medical training where optimal stress level facilitates the learning and adapting process among doctors, moulding them into holistic experienced doctors. Such manner of stress is known to be the Favourable stress, whereby the magnitude of stress that suppresses the learning, decision making and function of a doctor is known as the unfavourable stress(Sadock, 2000).
What happens to be the root cause of such predicament among our housemen? Well, psychological distress itself is a subjective matter. Thus, to pinpoint one sole cause which predisposes to the phenomenon is vague, bringing it to be rather a multifactorial agenda. The common stressors which induce Physiological distress amongst any medical personnel are a plenty. Various studies have identifies this relationship, and not one sole factor comes into play(Chan, Lai, Ko, & Boey, 2000). Houseman themselves are the future of the medical profession. The challenges and trials faced by the newer generation are very much different from the previous generation. In order to foster good doctors in training, psychological distress in doctors should be identified and addressed properly.

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