INTERVIEW. Non-compliance with safety rest, overwork in hospitals and the absence of peer support weigh heavily on the minds of future doctors.
It is a sad observation. Future doctors are more prone to depression and suicidal thoughts than the general population, reports an unpublished survey conducted by 4 unions of medical students and young doctors (Isni, Anemf, Isnar, Isncca), among 21,000 future or young doctors.
This survey reveals that two thirds of future doctors suffer from anxiety, almost a third from depression, ie proportions twice as high as those found among the French. Caregivers who are also more likely to be crossed by suicidal thoughts (24% against 20% in the general population).
If for the youngest, especially day students, anxiety disorders are mainly linked to the preparation for the boarding school competition at the end of the 6and year, the interns suffer above all from the working conditions in the hospital. In one out of two cases, the safety rest of 11 hours after a 24-hour shift is not respected, underlines the survey.
This overload of work, to which is added a feeling of loneliness and abandonment, promotes the deterioration of the mental health of medical students, explains Olivier Le Pennetier, president of the InterSyndicat National des Internes (Isni).
Do future caregivers dare to speak out about their discomfort?
Olivier Le Pennetier: It’s a taboo. We can hear: “If he is not well, it is his problem”. It’s wrong. If all the staff in a department are not doing well, there is a problem in the department. This can be related to working conditions, to the management of the service. We have the right not to be well.
Several events pushed this idea forward. Unfortunately, these are often tragic moments like the repeated suicides of interns or nurses. The book by Dr Valérie Auslender, Omerta in the hospital, has also made it possible to combat this stigma. This is a global questioning of the system.
Olivier Le Pennetier, President of the National Intersyndicate of Interns
How can this prevalence of mental disorders be explained?
Olivier Le Pennetier: We were able to identify risk factors and protective factors. Among them, coaching and peer support play a key role. Quality support, with the establishment of regular discussion times in the service, can reduce the risk of depression. On the contrary, the pressure exerted by the hierarchy can aggravate it.
The survey also highlights low use of occupational medicine. However, it can defuse certain situations. This is why we wish to emphasize the importance of these consultations.
The organization and management of services, with in particular respect for working hours, are also psychosocial risk factors.
Precisely, the investigation shows that respect for safety rest is still not respected…
Olivier Le Pennetier: It has been compulsory since 2002 but, in fact, we are regularly obliged to call the CHUs to order. However, it is very important that young doctors, like doctors for that matter, rest after having worked 24 hours continuously. Failure to comply with safety rest jeopardizes the care provided to patients.
One can think that the economic management of health establishments is not unrelated to this non-compliance with the regulations. It is therefore essential that the training of doctors evolve in order to improve working conditions in hospitals.
You also propose to integrate management training…
Olivier Le Pennetier: We think it is very important that future doctors know how to organize and manage a team. Learn to work in a team, in fact. All that, we don’t learn it in college, when it’s really lacking. Being trained in the prevention of psychosocial risks will make it possible to change the situation in the hospital.
.