Mental health care use among resident physicians compared with the general population

Background — Surveys suggest mental health conditions are more common among physicians than the general population. However, whether these challenges are being driven by profession specific factors compared to broader societal change is unclear. Little is known about whether these challenges disproportionately affect resident physicians, who may experience unique stressors, or differ by sex.

Objective — To examine sex-based mental health visits among physicians in residency relative to non-physicians.

Design, setting, and participants — We conducted a retrospective, sex-stratified, population-based cohort study of resident physicians matched (1:5 on index year, sex, age, rurality, and income quintile) to non-physicians from April 1, 2004, to March 31, 2018.

Main measures — Mental health visit rates during the five-year residency period, defined by any diagnostic or billing code for a mental health condition, compared to non-physicians.

Key results — We included 10,925 resident physicians and 54,625 matched non-physicians (mean [SD] age, 27.2 [3.0] years; 5,941 [54.37%] female physicians; 4,984 [45.62%] male physicians). Overall, 34.35% of physicians had a mental health visit compared to 36.13% of non-physicians. Anxiety was the most common diagnosis across all groups, highest among female physicians (67.38% of visits). Among physicians, females had a higher risk of a mental health visit than males (adjusted HR, 1.44; 95% CI, 1.35–1.54). Comparing physicians to non-physicians, female physicians were less likely to have a mental health visit than female non-physicians (39.71% vs 41.24%; adjusted HR, 0.89; 95% CI, 0.85–0.93). A similar pattern was observed among male physicians compared to male non-physicians (27.97% vs 30.03%; adjusted HR, 0.81; 95% CI, 0.76–0.85).

Conclusions — One in three physicians had a mental health visit during their residency. However, visit rates were lower than those of matched non-physicians, despite persistent concerns about physician mental health. Female physicians were more likely than male physicians to seek care, mirroring the general population.