Science & Education
There are many consequences to the long hours and high levels of stress that are seen in medical training today (1–6), even if the conditions have improved from those a decade ago. There are high rates of drug abuse involving the most commonly abused drugs of alcohol and marijuana, as well as fairly high rates of tranquilizer use (estimated at 11%), cocaine use (estimated at 9%), and opiate use (also estimated at 9%). Sadly, the most common reason for drug use and abuse is “self-treatment for stress.” The rate of burnout among medical trainees has been shown to be very high—as high as 76% (4); and rates of mental illnesses, such as anxiety and depression, have been shown to be in the 30%–40% range (2). Sadly, up to 25% of trainees report suicidal ideation at some point (6). The rate of marital problems is also high and is estimated at 40%.
There is no evidence that picking the wrong specialty will cause the signs and symptoms that the fellow is currently demonstrating, although it could conceivably be a contributing factor. The single best answer is C.