Work-family conflict helps explain gender gap in doctors’ depression

(Reuters Health) - Female doctors in training may be more likely to become depressed than their male counterparts at least in part because of difficulties balancing work with family life, a U.S. study suggests.

Researchers examined survey data from 3,121 medical residents, or physicians in training, and found no meaningful differences between men and women in work-family conflicts reported before they started their labor-intensive internship year.

But six months into their internships, women reported significantly more conflicts between work and family than men. More work-family conflict was associated with increased symptoms of depression, the study also found.

“The current study adds to our understanding of when in medical training the gender disparity in depressive symptoms and work-family conflict emerge, and demonstrates that work-family conflict increases the risk for depressive symptoms in both men and women,” said lead study author Dr. Constance Guille, a researcher at the Medical University of South Carolina in Charleston.

“Importantly, work-family conflict helps explain why women have higher depressive symptoms during internship year compared to men.”

Depression is common among training physicians, affecting up to 30 percent of residents, and it’s associated with lower-quality patient care, medical errors and career burnout, researchers note in JAMA Internal Medicine.

Despite the increased role of women in the medical profession, female doctors still take on significantly more household and childcare responsibilities than their male counterparts, researchers note.

In the current study, participants were 28 years old on average and roughly half were women. Roughly half of the women reported a history of depression, compared with 42 percent of the men.

Men, however, were more likely to be married or engaged and have children.

The sex difference in depression symptoms was less pronounced once researchers accounted for work-family conflict.

One limitation of the study is that researchers relied on survey participants to report their own depressive symptoms, and this wasn’t verified by clinicians or by medical records. In addition, many training physicians invited to participate in the study either declined or failed to complete the follow-up survey.

Even so, the findings highlight a need to do a better job of detecting and treating mental health problems among doctors in training, Judy Shea of the Perelman School of Medicine at the University of Pennsylvania in Philadelphia writes in an accompanying editorial.

“The start of internship is an emotional time,” Shea said by email. “For many, the joy of graduation and excitement (and fear) of internship is tempered by the reality of moving to a new town, leaving friends and family behind.”

This affects both men and women, she said.

“That said, life-work conflict in medicine disproportionally affects women trainees given that extended training occurs during early adulthood, often conflicting with broader life goals,” Shea added.

It’s possible that the differences between work-family conflict and depression rates for men and women would be more dramatic if the study focused on just doctors with families, instead of a broad population of medical residents who for the most part were not parents, noted Dr. Anupam Jena, a researcher at Harvard Medical School and Massachusetts General Hospital in Boston who wasn’t involved in the study.

“I think that the differences would be more stark if we looked at men and women with families, because it is in those exact settings that real trade-offs between work and family have to be made,” Jena said by email.

These trade-offs are by no means unique to medicine, Jena added.

“I think you observe it in law, at high ranks of business, and other demanding occupations,” Jena said. “I also am not sure that the problems of depression and burnout that we observe in medicine are solely a function of how difficult medicine is.”

SOURCES: and JAMA Internal Medicine, online October 30, 2017.