Residency creates family and community, as trainees spend a substantial amount of time in this setting, and as such it needs to be a supportive culture to keep its members well.
     “Promotion of Wellness and Mental Health Awareness Among Physicians in Training.” JGME.

Decades of research studies and scholarly articles have explored physician mental health in four main areas: well-being, burnout, depression, and suicide. Health care organizations continue to make progress toward developing the necessary steps to ensure physician well-being. The ACGME Scholars in Residence have dedicated tremendous time and resources to reviewing and aggregating data about the factors that enhance or diminish physician well-being in the clinical setting.

The articles and videos below provide insight into the statistics and theories behind physician well-being.
* indicates you must be a subscriber to see the full text

Scholarly Articles


Salles, A., Liebert, CA, Greco, RS. “Promoting Balance In The Lives Of Resident Physicians: A Call To ActionJournal of American Medical Association Surgery. 150 (7). July 2015. 607-608.*

Ludmerer, Kenneth M.Let Me Heal: The Opportunity to Preserve Excellence in American Medicine. Oxford University Press. April 2015.

West, CP, et. al. “Intervention To Promote Physician Well-being, Job Satisfaction, And Professionalism: A Randomized Clinical TrialJournal of American Medical Association Internal Medicine. 174 (4). April 2014. 527-533.

Yurkiewicz, I. “Bullying Doctors Are Not Just Unpleasant, They Are Dangerous. Can We Change The Culture Of Intimidation In Our Hospitals?Aeon. January 29, 2014.

Ey, S., Moffit, M., Kinzie, JM, Choi, D., Girard, DE. “If You Build It, They Will Come: Attitudes of Medical Residents And Fellows About Seeking Services In A Resident Wellness ProgramJournal of Graduate Medical Education. 5 (3). September 2013. 486-492

Sen S, Kranzler, HR, Didwania, AK, Schwartz AC, “Effects Of The 2011 Duty Hour Duty Hour Reforms On Interns And Their Patients: A Prospective Longitudinal Cohort StudyJournal of American Medical Association Internal Medicine. 173 (8). April 23, 2013. 657-662.

Desai, SV, et. al. “Effect Of The 2011 Vs. 2003 Duty Hour Regulation-Compliant Models On Sleep Duration, Trainee Education, And Continuity Of Patient Care Among Internal Medicine House StaffJournal of American Medical Association Internal Medicine. 173 (8). April 22, 2013. 649-655.

Leape LL, Shore MF, Dienstag JL, Mayer RJ, Edgman-Levitan S, Meyer GS, Healy GB. “Perspective: A Culture Of Respect, Part 1: The Nature And Causes Of Disrespectful Behavior By PhysiciansAcademic Medicine: Journal of the Association of American Medical Colleges. 87 (7). July 2012. 845–852.

Leape LL, Shore MF, Dienstag JL, Mayer RJ, Edgman-Levitan S, Meyer GS, Healy GB. “Perspective: A Culture Of Respect, Part 2: Creating A Culture Of RespectAcademic Medicine: Journal of the Association of American Medical Colleges. 87 (7). July 2012. 853–858.

Eckleberry-Hunt, Jodie, Van Dyke, Anne, Lick, David, Tucciarone, Jennifer “Changing the Conversation From Burnout to Wellness: Physician Well-being in Residency Training Programs. Journal of Graduate Medical EducationJournal of Graduate Medical Education. (2). December 2009. 225-230.

Wallace, JE, Lemaire, JB, Ghali, W. “Physician Wellness: A Missing Quality IndicatorLancet 374 (9702). November 14, 2009. 1714-1721. *

Swetz. KM, Harrington. SE, Matsuyama, RK, Shanafelt, TD, Lyckholm, LJ. “Strategies For Avoiding Burnout In Hospice And Palliative Care Medicine: Peer Advice For Physicians On Achieving Longevity And FulfillmentJournal of Palliative Medicine. 12 (9). 2009. 773-777. *

Levy, RE.“Sources Of Stress For Residents And Recommendations For Programs To Assist ThemAcademic Medicine: Journal of the Association of American Medical Colleges. 76 (2). February 2001. 142-150.


Shanafelt, TD, “Burnout and Satisfaction with Work-Life Balance Among US Physicians Relative to the General US Population.” Archives of Internal Medicine. 172 (18). October 8, 2012. 1377-1385.

West CP, Shanafelt TD, Kolars, JC. “Quality Of Life, Burnout, Educational Debt, And Medical Knowledge Among Internal Medicine Residents.Journal of American Medical Association. 306 (9). September 7, 2011. 952-960.

Ghetti, Chiara, Chang, Judy, Gosman, Gabriella. “Burnout, Psychological Skills, and Empathy: Balint Training in Obstetrics and Gynecology Residents.” Journal of Graduate Medical Education. 1(2). December 2009. 231-235.

Ishak, WW, Lederer, S, Mandili, C, Nikravesh, R, Seligman, L, Vasa, M, Ogunyemi, D, Bernstein, CA. “Burnout During Residency Training: A Literature Review.” Journal of Graduate
Medical Education. 1(2). December 2009. 236-242.

Ludmerer, Kenneth M. “Resident Burnout: Working Hours or Working Conditions?Journal of Graduate Medical Education. 1(2). December 2009. 169-171.

Dyrbye, LN, “Burnout And Suicidal Ideation Among US Medical Students.” Annals of
Internal Medicine. 149 (5). September 2008. 334-342. *


Rubin, R. “Recent Suicides Highlight Need To Address Depression In Medical Students And Residents.Journal of American Medical Association. 312 (17). November 5, 2014. 1725-1727.*

Moutier C, Norcross W, Jong P, Norman M, Kirby B, McGuire T, Zisook S. “The Suicide Prevention And Depression Awareness Program At The University Of California, San Diego School of Medicine.Academic Medicine: Journal of the Association of American Medical Colleges. 87 (3). March 2012. 320-326.

Roberts, LW. “Understanding Depression and Distress Among Medical Students.Journal of American Medical Association. 304 (11). September 15, 2010. 1231-1233. *

Schwenk, TL, Davis, L., Wimsatt, LA. “Depression, Stigma, And Suicidal Ideation In Medical
Students.Journal of American Medical Association. 304 (11). September 15, 2010. 1181-1190.

Sen, S, Kranzler, HR, Krystal, JH, Speller, H, Chan, G, Gelernter, JG, Guille, C. “A Prospective Cohort Study Investigating Factors Associated With Depression During Medical Internship.Archives of General Psychiatry. 67 (6). June 2010. 557-565

Downs N, Feng W, Kirby B, McGuire T, Moutier C, Norcross W, Norman M, Young I, Zisook S.
Listening To Depression And Suicidal Risk In Medical Students: The Healer Education Assessment And Referral (HEAR) Program.Academic Psychiatry. 38 (5). October 2014. 547-553. *

Center, C, “Confronting Depression And Suicide In Physicians: A Consensus Statement.Journal of American Medical Association. 289 (23). June 18, 2003. 3161-3166. *


Gawande, A. “Oliver Sacks.” The New Yorker. September 14, 2015. 38-39.

Eneroth M, Senden MG, Lovseth LT, Schenk-Gustafsson KS, Fridner A. “A Comparison Of Risk
And Protective Factors Related To Suicide Ideation Among Residents And Specialists In Academic Medicine.Bio Med Central Public Health. 14. March 20, 2014. 271-280.

Gold KJ, Sen A, Schwenk TL. “Details On Suicide Among US physicians: Data From The
National Violent Death Reporting System.General Hospital Psychiatry. 35 (1). January-February 2013. 45-49.

Austin AE, van den Heuvel C, Byard RW. “Physician Suicide.Journal of Forensic Science. 58 (S1). January 2013. S91-93. *

Shanafelt, TD, “Suicidal Ideation Among American Surgeons.” Archives of Surgery. 146
(1). January 2011. 54-63

Hem EH, Haldorsen T, Aasland OG, Tyssen R, Vaglum P, Ekeberg O. “Suicide Among Physicians.” The American Journal of Psychiatry. 162 (11). November 2005. 2199-200.

Schernhammer, E. “Taking Their Own Lives - The High Rate Of Physician Suicide.” New England Journal of Medicine. 352 (24). June 16, 2005. 2473-2476. *

Schernhammer ES, Colditz GA. “Suicide Rates Among Physicians: A Quantitative And Gender Assessment (Meta-Analysis).” The American Journal of Psychiatry. 161 (12). December 2004. 2295-2302.

Boxer PA, Burnett C, Swanson N. “Suicide And Occupation: A Review Of The Literature.” Journal of Occupational and Environmental Medicine. 37 (4). April 1995. 442-452. *

Arnetz BB, Hörte LG, Hedberg A, Theorell T, Allander E, Malker H. “Suicide Patterns Among Physicians Related To Other Academics As Well As To The General Population. Results From A National Long-term Prospective Study And A Retrospective Study.Acta Psychiatrica Scandinavica. 75 (2). February 1987. 139-143. *

If you are in crisis, please call the National Suicide Prevention Lifeline at 1.800.273.TALK (8255), or contact the Crisis Text Line by texting TALK to 741741

Contact Us

For questions about the ACGME’s Physician Well-Being Initiative, or to submit tools and resources for consideration for the website, email


Visit the JGME website for the latest research in graduate medical education.

For articles concerning physician well-being, click here.