When residents need health care: stigma of the patient role

Acad Psychiatry. 2009 Nov-Dec;33(6):431-41. doi: 10.1176/appi.ap.33.6.431.


Objective: Whether and under what circumstances medical residents seek personal health care is a growing concern that has important implications for medical education and patient welfare, but has not been thoroughly investigated. Barriers to obtaining care have been previously documented, but very little empirical work has focused on trainees who seek health care at their home institution.

Methods: A self-report survey on special issues in personal health care of residents was created and distributed at the University of New Mexico School of Medicine in 2001. The authors report findings regarding stigma, fear of jeopardy to training status, and attitudes toward seeking self-care for residents in dual roles as patients and trainees.

Results: Residents (N=155) rated their concerns regarding stigma and jeopardy to training status and the likelihood of seeking care at their training institution for six vignettes. The vignettes were paired to make comparisons between attending or supervisor as treating physician and between clinical scenarios. Alcohol abuse, nausea and diarrhea, panic attacks, and pregnancy were the most highly stigmatizing to residents; diabetes and hypertension were the least. Differences were also found for gender and specialty.

Conclusion: Residents' perceived stigma for clinical situations was an influential factor, strongly affecting concern about jeopardizing training status and likelihood of avoiding care at their home institution.

MeSH terms

  • Achievement
  • Adult
  • Alcoholism / psychology
  • Alcoholism / rehabilitation
  • Clinical Competence
  • Confidentiality
  • Conflict, Psychological
  • Data Collection
  • Denial, Psychological
  • Education, Medical, Graduate*
  • Female
  • Health Knowledge, Attitudes, Practice
  • Health Services Accessibility
  • Health Services Needs and Demand*
  • Humans
  • Interdisciplinary Communication
  • Internship and Residency*
  • Male
  • Medicine
  • Middle Aged
  • New Mexico
  • Patient Acceptance of Health Care / psychology*
  • Physician Impairment / psychology*
  • Physician's Role / psychology
  • Pilot Projects
  • Prejudice*
  • Psychiatry / education*
  • Self Care / psychology
  • Sick Role*
  • Social Perception
  • Social Support