Genes Tell the Story: Young Doctors Age Too Quickly

Newly minted physiological data show just how harmful stress can be on medical residents.

Researchers looked at what happened to the telomeres of 250 first-year residents before and after they began their residency, and it’s not good. Telomeres guard against DNA damage and as Dhruv Khullar, MD, points out in the New York Times, when they shrink to a certain level cells tend to self-destruct, adding to the aging process.    

“Telomeres usually shrink at a rate of about 25 DNA base-pairs per year, but first-year medical residents experienced a decline of more than 140 base-pairs on average,” writes Khullar, the director of policy dissemination at the Physicians Foundation Center for Physician Practice and Leadership. When a resident works more than 75 hours a week (not unusual), telomere shrinkage soars to over 700 base-pairs, adds Khullar, citing a new study in Biological Psychiatry.  

Srijan Sen, MD, the study’s senior author and an associate professor of psychiatry at the University of Michigan, said that “most prior research on residency well-being has used self-reported questionnaires. We hope that showing measurable physiological effects at the cellular level will help catalyze residency reforms that really move the needle.”

Khullar, who is also assistant professor of health care policy at Weill Cornell Medicine, has some ideas. How residents put in those hours also matters. Too many day-to-night shift transitions can lead to circadian rhythm disruptions. Also, young doctors don’t tend to follow their own advice to patients when it comes to eating healthy and preventive health. Hospitals should encourage residents have regular physicals and access to psychologists, and ensure the availability of healthy food.

“And having more flexibility and autonomy over one’s work schedule is critical,” writes Khullar. “Long hours are tough, but having to miss a close friend’s wedding is what really hurts.”