Study objective: To compare the levels of work-related stress and depression reported by physicians-in-training in emergency medicine in three survey sites and to determine the effects of gender and marital status on stress and depression among these physicians. Design: Cross-sectional mail surveys. Setting and type of participants: Physicians-in-training in the United States, United Kingdom, and Australasia. Intervention: Questionnaires requesting demographic information and including scales assessing work-related stress and depression were administered. Measurements and results: A 3 × 2 × 2 multivariate analysis of variance in which survey site, gender, and marital status were independent variables and stress and depression scale scores were dependent variables revealed significant differences when stress and depression were analyzed simultaneously. Univariate analyses of variance revealed significant differences in stress by survey site and gender and in depression for all three independent variables. Comparison of adjusted means revealed that respondents from the United Kingdom reported significantly higher levels of stress than did respondents from the United States and that women reported significantly higher levels than men. Respondents from the United States reported significantly higher levels of depression than did respondents from the other countries, women reported higher levels than men, and unmarried respondents reported higher levels than married respondents. Conclusion: Despite limitations resulting from self-report bias, cross-sectional survey methodology, sampling error, and differences in training among the three survey sites, the respondents experienced similar levels of stress and depression attributable to anticipated sources. © 1991 American College of Emergency Physicians.
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