We found that, in this sample, enthusiasm at the beginning of internship soon gave way to depression, anger, and fatigue. Future research should be aimed at determining whether these changes persist beyond internship.

Given the association between chronic sleep deprivation and mood disturbances during internship, outcome assessment is warranted to see if duty-hour reform will translate into more hours slept or fewer hours worked, coincident with improved mood.

for all ACGME-accredited residency programs. 2,3 Work limitations for residents included no more than 80 hours per week, with 1 day in 7 free of all duties, averaged over 4 weeks; no more than 24 continuous hours with an additional 6 hours for education and transfer of care; in-house call no more frequently than every third night; and at least 10 hours of rest between duty periods. 2 Although there is extensive scientific evidence linking fatigue and impaired cognitive performance, 4-9 little empirical data guided the design of the duty hour regulations, 10,11 and the design itself remains controversial, 12,13 with contrasting views as to whether the duty See also pp 984 and 1055.

Internal medicine residency presents challenges resulting in common mood disturbances. Although graduating residents appear to be better off than the population norms, some domains of their mood disturbances and empathy never fully recover from their internship year.