Is There a Relationship Between Job Stress and Performance Among the Medical Interns


Job overload disrupts the synchronization that exists between the natural environment and the internal clock of our body. Due to this disruption, the medical interns suffer from social isolation, increased injuries, accidents, and sleep disturbances. They also suffer from various physiological effects like changes in, the rhythms of their core temperature, their immune functioning, their various hormonal levels, and their activity rest cycles (Swansburg, 2005)

Thus, the prime concern of this paper is to identify and determine if there is a relationship between job stress and performance among medical interns or not. It has also been attempted to justify the nature of workload-related ailments in a positive manner and probable way out or remedies in these conditions. The problem or issue that has been discussed in this study is regarding the impact of physiological or psychological stress effects on medical interns, who have to work long night shifts, on the safety of their patients. The medical interns who have to work on their duty, particularly, night shifts have to face a number of social and health-related problems.

Literature review

Due to high stress, their body feels fatigued and their health deteriorates because of stress. The different psychological effects arise due to social isolation as night shifts disrupt their personal and family life-giving rise to relationship and communication problems and issues. Thus, slowly their tiredness and fatigue become apparent in their work, which brings us to the issue of patient safety. Although many people may not be aware of the impacts of the above problem, its effects could be severe on the patients as the general performance level of the affected individuals is sure to suffer. The medical interns with their long hours of work and, sometimes, mandatory night shifts have to face problems with their mental and physical health, affecting their work and quality of care for patients. Due to their emotional exhaustion, the medical interns become irritated and their relation with the patients becomes sour.

Some studies regarding patient safety due to the impact of mental and physical health of the medical interns were conducted after in 1999 by the Institute of Medicine or IOM had announced that around ninety-eight thousand people in the US annually die due to mistakes made by hospitals. Institute of Medicine had carried out another survey in 2003 on the various factors in the nursing profession and their impact on the safety of the patient. They had concluded saying that ample evidence had been found associating long night shifts and the nursing staff with numerous errors and extremely adverse reactions, like urinary tract infections, pneumonia, infection after operations, and some patients even had to increase their stay in the hospitals. (Doyle, 2003)

Institute of Medicine also found that if these medical interns are made to work in shifts that are longer than 12 hours a day then they endanger their patient safety because of their fatigue. They do not pay proper attention to their patients since they fall asleep while on duty further increasing the risk of making life-threatening errors. Institute of Medicine further reported that due to their physiological and psychological problems the medical interns start to ignore the acute needs of their patients most of whom cannot even get out of their beds and thus, cannot call for help.

Thus, it is not a surprise for us that the risk of making severe errors increases by almost three times when the medical interns have to work longer hours without any sleep or proper break between their shifts. It has also been observed that no matter how long the night shifts are scheduled to be for the medical interns, working at late hours always increases the odds of causing a minimum of one error per patient. In addition, almost two-thirds of the medical interns having to work night shifts fall asleep while on duty. This leaves the patients in a very vulnerable situation.

These medical interns working exhausting long night shifts not only have to face strain and exhaustion but also have to fight back against their standard circadian rhythm and also their biological propensity of falling asleep. Institute of Medicine observed that a majority of medical interns became highly irritated while attending the patient’s call making it difficult for the patients too. The patients are not taken proper care of and just like the medical interns; they too suffer from stress and fatigue. However, in their cases, this stress or fatigue could be very harmful especially if they are old or are suffering from a major illness. In 1999 a study carried out by the Minnesota Medical interns Association which is affiliated with the United American Medical interns, observed that more than two-thirds of the medical interns expressed intensifying frustration towards their job and more towards their patients when having to work at night shifts without rest.

A lot of research has been done, mainly by the Institute of Medicine to find out about this problem and the sole result of all the researches is that these medical interns need proper sleep and rest if they are required to take good care of their patients and show efficiency in their work. If this problem persists then not only will the lives of the patients be in danger but also the medical interns will face accidents and injuries in their lives. In addition, their job satisfaction will be very low, due to which the customer satisfaction of the patients and their families will also decrease. (Page, 2004)

Definition of the problem

The main question that needs to be answered regarding the above problem is how much the medical interns should put into their work so that they do not suffer from stress or fatigue and at the same time are efficiently able to care for their patients. The Institute of Medicine has recommended the hospitals that the state has strictly prohibited medical interns to work no more than twelve hours in a minimum of twenty-hour period which comes to at the most sixty hours of work per week. This includes both their night and day shifts. These figures have to be maintained if we want the medical interns to take care of their patients effectively. Thus, it is important to establish the relation between stress and performance in order to justify the decision.

Research question

Is there a relationship between job stress and performance among medical interns?

Theoretical framework

The interviews and questioners would certainly include the Administrators, Managers, medical experts and scholars, senior managers, and obviously the medical interns along with patients. The involvement of the administrators is a logical conclusion, as this is the main stronghold that would be able to render the impetus of the market with his valued opinions. It should be noted that the interviews of the organization managers would be very helpful as they are the person who directly understands the ground reality of the nature and feasibility of the schedule plans. Scholars and experts are also important for the basic strategy development these are the people who would be able to provide the theoretical framework of the entire project. Interviews of the senior administrators, Journalists, and patients are very important because not only these people are well respected and their words highly valued, these are the people who can influence the structure of the healthcare segment with their experience and insights. Lastly, the interview would also be taken of experienced medical interns because they are the key objective of the entire scenario and these are the people who would actually present the objective of the market and would be instrumental directly to make the study worth venturing.


The purpose of this study is to identify and describe the possibility of medical interns on the basis of their ability to perform optimally under stress and the emotionally tasking situations encountered during healthcare proceedings.


Throughout the procedure, it should be noticed whether there are specific variables within the testable population or not. These variables would be extremely important while evaluating the basic data in the final stages where the adjustments would be made to the formulated data in accordance to the observations. However, it is important to completely take into account the aspects of fundamental variables of an individual such as ethnicity, religious belief or positive support from the healthcare professionals of the management and individual.


In accordance to the initial literature review it could ascertained that there is a definite relation between job stress and performance among the medical interns.

Research design

It can always be stated that Qualitative research is a process that includes interpretative paradigm under the measures of theoretical assumptions and the entire approach is based on sustainability that is depended on people’s experience in terms of communication. It can also be mentioned that the total approach is because reality is created on the social formulations. It can also be mentioned that the basic target of qualitative research is instrumented towards social context under normal circumstances where it would be possible to interpret, decode and describe the significances of a phenomenon. The entire process is operational under the parameter of interpretative paradigm that can minimize illusion and share subjectivity under contextualization, authenticity and complexity of the investigation. (Rigby, 2005) Thus, this method would be used for this paper.

Data collection and analysis

As descriptions of statistical methods that will be used it could be stated that in order to isolate the results for this particular study, only a survey questionnaire done would have been utilized. These questionnaires would be delivered to interns and patients along with the administrators of the events. The results were divided into these same categories to ensure validity and reliability. General information in regard to identifiers was utilized in order to ensure that there would be no bias. The validity was managed as a result of this focus and emphasized in the considerations involved in the data collection, variables, and sampling methods. Privacy and confidentiality methods included assigning numeric and alphabetic coding to each responding questionnaire. This ensured anonymity in regard to the researcher and the subjects of the research process and a thorough qualitative method would be used during data analysis. (Dollard, 2006)

The analysis revealed that it should be noted that there is no single performance scale or generalization for stress related toll. However, it was established that it is obvious from the analysis that the main aspect of medical intern’s burn out is due to stress and stress results in lower performance. Thus it is important to find out the reasons of stress like monotonous work schedule and work methods in further studies. Thus it is important to try newer pastures in the present form of scheduling. The way out may be yoga class or similar sort of stress relief procedures. Thus, the analysis definitely suggested that there was a relation between stress and performance and thus the performance suffer by a good margin if the medical interns are in stress.


It was found that there was a define relation between stress and performance. Thus, it should be noted that the hospital authorities should not force the medical interns and threaten them with their jobs, as this will only jeopardize the lives of the patients under their care. The medical interns should be slowly let to adjust themselves to the shifts and should learn how they can adjust their internal rhythms to their working hours. Only when the medical interns feel good about their work will they be able to take proper care of their patients. A study by the Stress journal also reports that to reduce errors in patient care the medical interns should complete all challenging work before 4 am and then get proper rest. (Perrons, 2006)


Dollard, J. (2006). Aggression in Decision Building. New Haven and London: Yale University Press.

Doyle, CE. (2003). Work and Organizational Psychology: An Introduction with Attitude; NY: Psychology Press.

Page, A. (2004). Keeping Patients Safe: Transforming the Work Environment of Nurses; LA: Institute of Medicine (U.S.). Committee on the Work Environment for Nurses and Patient Safety; National Academies Press.

Perrons, D. (2006). Gender Divisions and Working Time in the New Economy: Changing Patterns of Work, Care and Public Policy in Europe and North America; NY: Edward Elgar Publishing.

Rigby, B. (2005). Design of Services. 4Th Ed. New York: Taylor & Francis Routledge.

Swansburg, RJ. (2005). Management and leadership for nurse administrators. Ed: 4. London: Jones & Bartlett Publishers.