Crisis-Related Self-Reported symptoms of posttraumatic stress disorder in graduate medical education trainees: Results from a Multi-Institutional study

Saadia Akhtar; Colin P West; Daniel V Satele; Celestine He; Larissa R Thomas; Diane Sliwka; Katherine A Julian; Liselotte N Dyrbye; I Michael Leitman; Jonathan Ripp

doi:10.1093/acamed/wvag157

Crisis-Related Self-Reported symptoms of posttraumatic stress disorder in graduate medical education trainees: Results from a Multi-Institutional study

Acad Med. 2026 May 21:wvag157. doi: 10.1093/acamed/wvag157. Online ahead of print.

Authors

Saadia Akhtar^{1

2}, Colin P West³, Daniel V Satele³, Celestine He⁴, Larissa R Thomas⁵, Diane Sliwka⁵, Katherine A Julian⁵, Liselotte N Dyrbye⁶, I Michael Leitman^{2

7}, Jonathan Ripp^{2

8

9}

Affiliations

¹ Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States.
² Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, United States.
³ Department of Medicine and Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, United States.
⁴ Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States.
⁵ Department of Medicine, University of California, San Francisco, San Francisco, CA, United States.
⁶ Department of Medicine, University of Colorado School of Medicine, Denver, CO, United States.
⁷ Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, United States.
⁸ Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States.
⁹ Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States.

PMID: 42179175
DOI: 10.1093/acamed/wvag157

Abstract

Purpose: Crisis periods-defined as sustained disruptions to the clinical environment resulting in increased workload, exposure to high-acuity patient care, or limited access to coping resources-can lead to posttraumatic stress disorder (PTSD) among residents and fellows (trainees). By examining self-reported pandemic-related PTSD symptoms, associated risk factors, and their consequences, this study aims to identify vulnerable groups and inform institutional strategies to support trainee well-being during and after crisis events.

Method: A multi-institutional cross-sectional survey was conducted at three U.S. academic medical centers between April-May 2022. Measures included the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5, range 0 to 5, scores ≥4 indicate probable PTSD), 4-item PROMIS Social Isolation scale (normed T-score range 0-100 scale with higher scores indicating greater isolation), items exploring intent to stay at one's institution, and demographics. Multivariable analysis adjusted for demographics, specialty, and post-graduate year.

Results: Of 6057 eligible trainees, 3185 (53%) participated in the survey, with 3109 completing the PTSD screening. A total of 190 (6%) trainees screened positive for self-reported PTSD symptoms. Multivariable analysis revealed that female trainees had a higher odds of screening positive for self-reported PTSD symptoms compared to males (OR 1.45, 95% CI 1.03-2.04, P=.03). Greater social isolation was independently associated with increased PTSD risk (OR 1.09, 95% CI 1.07-1.11, P<.001). Additionally, trainees who did not intend to remain at their institution after training were more likely to screen positive for PTSD (OR 1.74, 95% CI 1.17-2.58, P=.01).

Conclusions: Female gender, greater social isolation, and reduced intention to remain at one's institution are independently associated with self-reported PTSD symptoms in trainees. Recognizing these relationships may enable healthcare leaders to proactively identify trainees at higher risk during crisis periods and to implement targeted, evidence-based interventions that promote well-being and workforce retention.

Keywords: crisis; graduate medical education; medical trainees; posttraumatic stress disorder.

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