Registration of medical students by medical boards.

Phase 3 of the study is currently under way. One hundred and twenty students from the University of Sydney are being tested at six different times across their final medical school year (Year 4) and the internship year. The core measurement tools have again been administered and, in addition, the General Health Questionnaire,4 the International Personality Disorder Examination (IPDE, ICD-10 module) screening questionnaire5 and the Sheehan Quality of Life questionnaire.6 A key difference from previous studies is the inclusion of a one-on-one Life Events and Difficulties Scale (LEDS)7 interview at six-monthly intervals over the twoyear period. Preliminary findings from the mid-internship LEDS interview indicate some issues that appear to promote stress mid-internship. Poor-quality supervision is a common issue and appears to relate to the unsupportive, “burnt-out” or overworked registrar or term supervisor providing inadequate supervision. Similar issues arise in situations where appropriate levels of supervision are lacking, including at some rural allocation centres, and particularly in emergency situations or at night. Lack of debriefing measures after a critical incident was another common theme, as was dealing with emotionally difficult situations, such as giving bad news. Above all, administrative support issues appear to be very significant. A sympathetic administration ameliorates many of the other problems, but an unsympathetic one heightens the level of stress experienced.