Anxiety about professional future among young doctors.

OBJECTIVES The interest is focused on today's interns who will soon become an essential part of the health care system. Obstacles they perceive at the beginning of the career may encourage them or, inversely, impede their professional development, enhance professional burnout or even lead to change of the profession. International literature, comprising publications on the situation in ten European countries, Canada and the USA, is reviewed. Numerous considerations have encouraged some attempts to measure "anxiety about professional future" (AAF). MATERIALS AND METHODS Seven factors that induce anxiety about professional future among students and young doctors are listed and briefly discussed: 1) Difficulties in getting a job and growing anxiety for maintaining the job; 2) Low wages; 3) Negative impact of work on private and family life, in particular, a conflict between the professional role and mother's role; 4) Excessive level of organizational stress; 5) Lack of (individual) resources to cope with stress; 6) Institutional and financial limitations for professional development; and 7) Worldwide evolution of the professional role and the status of doctor. A questionnaire was developed by the author and answers were collected from a representative sample of Polish interns (about 1000) and a small sample of French interns. A scale for measuring the anxiety was built with use of factor analysis. RESULTS The resulting scale called AAF has proved to have good statistical properties. The mean value of the anxiety indicator proved to be high in Poland. Interns who are familiar with the doctor's daily duties, who feel economically independent and who have good self-valuation of the practical skills are characterized by a lower level of anxiety. AAF values in a sample of French interns was dramatically lower than those characteristic of Polish interns. CONCLUSIONS The values of AAF for the interns can be related to the intensity of stress-inducing factors in the professional environment. Very high AAF values can stem from an excessive professional stress that may have a negative impact on individual careers and the whole health care system in Poland. Appropriate changes in the curriculum of medical studies (accompanied by legal regulations) might reduce excessive anxiety about future in graduating doctors in Poland. Such changes could include: (a) a greater involvement of students in the examination and treatment of patients and in "daily life" in health care institutions; (b) making more practice (or performing medical procedures) obligatory; (c) creating better opportunities to earn living in the medical professions (by performing procedures or by assisting professionals); and (d) making efforts in the field of practical education more rewarding (e.g., introducing rating for practice and incorporating it into fellowship schemes).