Index IntroductionResearch methodsInclusion criteriaResultsProgram no. 1Program no. 2DiscussionIntroductionIt is widely recognized that the most difficult step in becoming a practicing doctor is specialization. During their specialization path, medical residents must learn to adapt to a lifestyle that is drastically different from the one they know: an experience that subjects interns to many difficulties and in many cases proves to be extremely distressing. Say no to plagiarism. Get a tailor-made essay on "Why Violent Video Games Shouldn't Be Banned"? Get an original essay In 2003, the Accreditation Council for Graduate Medical Education (ACGME) established a limit on hours of work and training, capping at 80 hours per week. In 2011 the regulation was revised again and the maximum duration of the duty period was limited to 16 hours. However, in 2017, the ACGME changed the program's common requirements policy and extended the service period from 16 hours to 24 hours. In Israel, resident doctors work an average of 26 consecutive hours per shift and often have to work without sleep. It is argued that this arises from the general perception that medical residents are young and more capable of working in all circumstances, without any regard for their health and quality of life. In 2013, a petition was submitted to the court by a residents' society against the "Clalit" health services and the Israeli Medical Association regarding their working conditions, which violate the Israeli law on working hours and rest. In response, the court decided to amend the clause that takes into account the working conditions of medical specialists. The law now suggests that medical residents should be allowed two hours of sleep during a shift if that option exists. Israeli medical specialists, however, maintain that this possibility does not exist due to the high demand for special posts.3 From these findings it can be deduced that the approach towards the working conditions of medical specialists is rather shaky and the possible implications they are not serious enough. Around 30% of young doctors have reportedly shown symptoms of depression, and the numbers are steadily increasing. The other two main disorders that accompany depression are anxiety and burnout. Depressed residents face the idea of ​​admitting they have a mental disorder and seeking treatment, which is considered a taboo topic in the medical community. Affected residents do not seek help because they believe it will jeopardize their careers. Unfortunately, the refusal of these residents to seek treatment, thanks to the combination of their extensive medical knowledge and access to various medical means – particularly drugs – has contributed to suicide, which accounts for 4% of all medical deaths. It can be assumed that this is a potentially dangerous situation that manages to spread more and more every year, claiming numerous victims in its path. To address this problem and eventually eradicate it, it needs to be taken more seriously by the medical community in particular, incorporating prevention programs into all hospitals and working towards an environment where asking for help is not considered taboo. The first aim of this research aims to investigate and understand the main causes behind the onset of these disorders, as well as demonstrate three main hypotheses: That the working conditions of the residence play a considerable role in the onset of depression, anxiety and burnout; That gender, maritality and socioeconomic status has little or no effectnull on the quality of life of medical specialists and their susceptibility to these mental disorders; the lack of prevention programs and the lack of willingness of residents to seek help will have a major impact on the quality of patient care and relationships with patients and the mental health of residents in the long term. A further aim is to evaluate the effectiveness of two programs that work for the prevention and optimization of the quality of life in medical specialists. Research Methods Two main questions are asked: "What are the causes of depression, anxiety and burnout in medical residents?" and “How can the onset of these disorders be prevented?” The first step to finding the solution to a problem is to identify the causes that cause it. If so, determine which aspect of the specialty causes medical residents to develop depression, anxiety, and burnout. Having established the causes of the prevalence of these disorders in medical residents and to eliminate them, it is important to consider a program that aims to find an effective prevention method. Inclusion criteria To ensure that this research discusses the topic effectively, the literature used was only chosen if it met the following criteria: only articles discussing medical residents suffering from depression, anxiety and burnout were chosen . The research methods used had to be based on questionnaires or observational studies of consenting resident physicians. The residents in question had to have no history of depression or anxiety before admission and finally the articles had to be in English, Spanish or Hebrew. Results In this research, seven research studies were used to identify the causes of the onset of depression, anxiety and burnout in medical residents around the world: 1 from Nigeria, 3 from Mexico, 2 from the United States and 1 from Japan. The methods for assessing depression, anxiety and burnout used in the research were: the Hamilton scale14 (HAM-D for depression and HAM-A for anxiety), the Maslach Burnout Inventory scale16, the Beck Depression Inventory scale12, the CES-D17 scale, the IM-ITE15 test, a questionnaire based on DSM-IV and ICD-1011, the Zung self-assessment scale13 and scale16 of the Harvard National Screening Day. The main causes identified for the prevalence of depression, anxiety and Burnout in medical residents worldwide is high job demands and long working hours, followed by changes in sleeping hours and eating habits. Other factors included overload of responsibilities, uneven division of labor, lack of time for study, self-involvement with patients (mostly by psychiatry residents), financial debt, aggressive conduct by senior doctors and lack of budget for health departments (in developing countries). As a result of the negative effect of these factors on their mental health, depressed residents were found to make six times more medical errors than their unaffected colleagues. Therapeutic decision making and diagnosis given have also been impaired by these factors, leading to a decline in the quality of patient care (leading in many cases to patient mortality and the patient-doctor relationship). The personalities of these residents have also been profoundly affected, causing them to become more apathetic and cynical. These qualities manifest themselves in how they approach patients, exacerbating the decline in the quality of patient care. In many cases, medical residents have gone so far as to contemplate suicide, and in some cases they have carried out the plan and taken their own lives. In most cases, yesfound that women were more likely to develop these disorders, followed by 1st and 2nd year residents. Other factors contributing to susceptibility were specialization; psychiatry, anesthesiology, and primary care residents were more likely to exhibit symptoms, the existence of debt greater than $200,000, and a low government budget for health care11; especially in developing countries like Nigeria. Marital status appeared to have little or no effect, but single residents were generally more susceptible. While it has been established in all research that there is a correlation between residency and the onset of these disorders, some have suggested that symptoms of depression, anxiety and burnout did not affect residents long-term, but eased after the first few. two months. However, the depersonalization symptoms persisted and affected their personality, manifesting mainly in cynicism, harsh attitude and apathy. Two programs were evaluated to identify the most effective prevention methods. Program no. 1 It consists of two main phases:a. The first phase focuses on an anonymous web-based survey that was distributed among participants. Of the 63 participants who completed screenings; 33% were referred to a counselor, 14% received a personal evaluation, and 22% were referred to a psychologist or psychiatrist.b. In the second phase, residents were invited to participate in a campaign consisting of workshops on physician burnout, depression and suicide, and destigmatizing help-seeking. Two main challenges have been identified:a. Not many residents responded to the invitation to participate. Most disturbingly, several facilities refused to participate, claiming there was no way they would have such problems in their facilities. Overall, this program proved to be a success. The responses were positive and 1/3 of the departments invited them for the second time. Program no. 2 This program worked alongside psychologists and psychiatrists. The staff's main goal was to enhance existing strengths that medical residents may have and help them develop resilience. Treatments and “booster sessions” were available throughout the program, as well as direct care and counseling and educational workshops focused on wellness promotion. Overall, a high level of satisfaction from residents and directors has been reported, and demand for this program increases each year. Discussion In light of the above findings, it is safe to say that the main hypothesis of this essay which believes that there is definitely true a direct correlation between residency and the onset of symptoms of depression, anxiety and burnout in medical residents. However, some studies suggest that these symptoms are only transient and will disappear once the first few months of adaptation have passed and will no longer be present in the long term. Another hypothesis that was proven incorrect by these articles was that gender would have little or no effect on susceptibility to these disorders. It has been shown that women are actually more likely to develop depression than men due to factors related to having to make their way in a predominantly male field, as well as the desire to have children. single residents were more likely to develop depression, the statistical gap was quite small and shows that, all in all, marital status plays an insignificant role. An interesting finding was that specialization can influence residents. It has been shown that there are more psychiatry residents.