Depression among Medical Trainees and Attending Physicians: Personal and Professional Risk Factors

Depression is common among physicians and has substantial implications for wellbeing, clinical functioning, and patient care. Physicians in early training are considered especially vulnerable, yet the combined contribution of personal characteristics, clinical factors, and occupational stressors remains insufficiently understood. This study examined depressive symptoms among medical students, interns, residents, and attending physicians in Israel. A cross-sectional survey was conducted among 366 participants between 2019 and 2021 using validated measures of depression, burnout, insomnia, perfectionism, and emotion regulation. Hierarchical regression analyses assessed the incremental contribution of demographic, personal, and clinical variables to depressive symptoms. An additional exploratory qualitative component among practicing physicians used semi-structured interviews to identify salient workplace stressors, quantify their frequency, and examine their association with depressive symptom levels. Insomnia emerged as the strongest predictor of depressive symptoms, surpassing the contribution of burnout. Maladaptive perfectionism and expressive suppression also significantly predicted depression. Together with demographic variables—particularly younger age, lower socioeconomic status, and prior psychiatric treatment—these factors explained more than half of the variance in depressive symptoms. Medical interns and residents reported higher depression scores than attending physicians, largely due to demographic differences. Follow-up analyses further showed that trainees had significantly higher insomnia and maladaptive perfectionism, suggesting additional psychological strains early in training. Qualitative findings highlighted interpersonal conflict and discrimination as prominent occupational stressors linked to depression. These results underscore the need for preventive strategies that address sleep hygiene, reduce maladaptive perfectionism, and foster supportive supervisory and interpersonal environments within medical training.