From doctors to students, women in medicine suffer more burnout and anxiety

A recent analysis by the Physicians Foundation showed a majority of physicians, residents and medical students are experiencing burnout and struggling with their well-being.

But a closer look at the data reveals a disturbing gender gap.

Female medical students and residents are more likely to say they are feeling anxious and hopeless, and female students are more likely to be considering dropping medical school. Female physicians are also more likely to be experiencing burnout than their male colleagues.

Gary Price, president of the Physicians Foundation, says the survey found a troubling gap among all women, from those who are physicians to those training for careers in medicine.

“It is concerning that almost across the board, there's really a significant difference,” Price says.

Some of the biggest disparities are seen in medical students.

Three-quarters (75%) of female medical students say they feel debilitating stress, compared to 51% of male students. More than 8 in 10 female medical students (81%), report inappropriate feelings of anger, anxiety and tearfulness, compared to 67% of male students.

More than one-third of female medical students (36%) say they’ve thought seriously of dropping out, while 23% of male students have said they’ve considered walking away.

Stefanie Simmons, chief medical officer of the Dr. Lorna Breen Heroes Foundation, which focuses on improving the mental health of healthcare workers, says the harassment of women training for careers in medicine is all too common.

“Micro- and macro-aggressions for any group is going to adversely affect their medical school experience, so certainly for women, but also for other minority groups, for the LGBTQ community, for religious minorities, for ethnic and racial minorities,” Simmons says.

Female medical students can experience inappropriate behavior, including sexual harassment, from colleagues, faculty and patients.

“Medical students are often in the room with patients in unprotected situations, and are at risk there,” she says. “So just as all healthcare workers are facing violence in the workplace right now, medical students are not protected from that.”

While many institutions have systems in place to report harassment from fellow students and teachers, Simmons says there aren’t always avenues to report harassment or inappropriate behavior from patients. She suggests hospitals should have zero tolerance policies for sexual harassment from staff and from patients.

Among female medical students, sexual harassment and even sexual assault is common and has been for years, Simmons says.

“I do not know a single medical student that I went through who was not assaulted in medical school,” she says. “I had significant assaults in medical school and residency, one that made me seek medical care, and that is by far the rule, not the exception.”

Sexual harassment is enmeshed in the culture of academic medicine, researchers have found.

Researchers surveyed more than 800 faculty members and found harassment and mistreatment based on gender, race and sexual orientation, according to a study published by the Journal of the American Medical Association on June 6.

“High rates of sexual harassment, cyber incivility, and negative organizational climate exist in academic medicine, disproportionately affecting minoritized groups and affecting mental health,” the authors of that study wrote.

Disparities emerge among medical residents in the Physicians' Foundation survey. More than three out of four female residents (77%) say they have inappropriate anger or anxiety, compared to 59% of men.

More than two-thirds (68%) of female physicians say they often have feelings of burnout, compared to 54% of male doctors.

Nearly half of women physicians surveyed (47%) said they didn’t seek care or knew someone who opted against getting help for fear of being asked about their mental health in licensing or credentialing questions. By comparison, 37% of male doctors expressed that sentiment.

Price says there needs to be more work to understand why female physicians are suffering more stress.

“I think there is room though, really to find out more about what's the environment like for female physicians that's leading to this disparity in stress levels. And unfortunately, the female physician suicide rates are also significantly higher than male physicians. That's a great concern,” Price says.

Some women have been leery of pursuing certain specialties in medicine because they are male-dominated, researchers have found. A February 2022 analysis in Jama Surgery continued to find large gender gaps in some surgical areas, including orthopedics and neurosurgery.

Simmons points out that high stress levels are driving some female doctors out of the profession, and some from entering the field.

“People are retiring earlier, because they don't want to deal with these stressors,” Simmons says. “People are leaving medicine mid-career. And we have talented students who are either not choosing to go into medicine, or are choosing not to go into specialties where they are particularly at risk, like emergency medicine.

“And we need clinicians to stay in all three of those areas, whether they're physicians or nurses at the beginning, during and at the end of their careers because we're losing not only our new students, who are the future of medicine, but our experienced clinicians, who are their teachers and their role models," she adds.

Creating a healthier workplace for women seems to be an essential goal to addressing the nation’s physician shortage. Women account for about 37% of the physician workforce, according to data from the Association of American Medical Colleges. More than half of all medical students are female, according to AAMC figures.

Health systems and hospitals can take steps to help women by making it easier for some to work on a part-time basis while they’re raising young children, Simmons says.

“There's really no reason why we can't accommodate parents, men or women, who want to be more involved with their children during the early years of their lives, and then come back into full-time later in their careers,” Simmons says. “We are draining a huge amount of talent out of the medical workplace by not offering flexible time in careers in medicine.”

Getting help

988 Suicide & Crisis Lifeline: Dial or text 988 to connect with someone. Help is available 24/7.

The American Foundation for Suicide Prevention offers resources for healthcare professionals.

NAMI: The National Alliance for Mental Illness offers “frontline wellness” resources for healthcare workers and public safety employees.