Original Article

International Archives of Occupational and Environmental Health

, Volume 82, Issue 1, pp 31-38

First online:

Work stress and reduced health in young physicians: prospective evidence from Swiss residents

  • Barbara Buddeberg-FischerAffiliated withDepartment of Psychosocial Medicine, Zurich University Hospital Email author 
  • , Richard KlaghoferAffiliated withDepartment of Psychosocial Medicine, Zurich University Hospital
  • , Martina StammAffiliated withDepartment of Psychosocial Medicine, Zurich University Hospital
  • , Johannes SiegristAffiliated withInstitute of Medical Sociology, Heinrich Heine University Dusseldorf
  • , Claus BuddebergAffiliated withDepartment of Psychosocial Medicine, Zurich University Hospital

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Job stress, investigated by the effort–reward model in various working environments in different countries, has been widely reported, yet studies addressing physicians are lacking. The present study investigated the perceived job stress, its association with the amount of working hours, and its impact on young physicians’ self-reported health and their satisfaction with life during residency.


In a prospective study design, a cohort of Swiss medical school graduates was followed up, beginning in 2001. In their second and fourth years of residency, 433 physicians assessed their effort–reward imbalance, overcommitment, physical and mental well-being and satisfaction in life. Taking the longitudinal design into account, four categories of stressed residents were defined: (1) subjects not reporting high work stress at either measurement, (2) subjects reporting high work stress in the second but not in the fourth year of residency, (3) subjects with onset of high work stress in fourth year and (4) residents reporting high work stress at both measurements.


All components of the perceived stress at work were significantly correlated with the amount of working hours, effort showing the highest correlation. While two-thirds of the participants do not report high work stress, assessed by the extrinsic part of the effort–reward imbalance model (the ratio between effort and reward) and 12% show a decrease of stress over time, there are 15% with an increase of stress over time, and 10% with persistently high stress experience. In terms of the intrinsic stress component (overcommitment), 71% show low values, 12% show a decrease, 9% an increase and 8% constantly high values. The groups with constant and increasing extrinsic and intrinsic stress experience exhibit significantly worse health and life satisfaction compared to the remaining groups, after controlling for gender and baseline health.


Stress at work in young physicians, especially when being experienced over a longer period in postgraduate training, has to be a matter of concern because of its negative impact on health and life satisfaction and the risk of developing symptoms of burnout in the long run.


Effort–reward imbalance Overcommitment Work stress Reduced health Residents Longitudinal study