The unspoken burden of MD anxiety
If we play a game of “fill in the blank” about physicians, plenty of descriptors pop to mind. Doctors are . . . high achievers. Doctors are . . . burnt out. Doctors are . . . overwhelmed with paperwork.
But are doctors . . . anxious?
Anxiety is a loaded term. It is frequently lumped in with depression, and vice versa—which makes sense given that, by some estimates, 60% of those suffering from anxiety will also exhibit signs of depression.
But of all the challenges physicians and medical learners may face in their careers, anxiety doesn’t seem to have been as thoroughly examined as a standalone problem. A 2019 position paper from the Canadian Psychiatric Association noted a contemporary survey by the Canadian Medical Association (CMA) revealed that while one in three doctors screened positive for depression,“Research on anxiety disorders in physicians is less robust and complicated by different assessment tools, but at least one older study of medical students reports higher rates of trait anxiety and symptoms of anxiety when compared with the general population,” wrote co-authors Drs. Michael Myers and Alison Freeland.
That paper underlines the importance of specificity. “There are numerous examples of physicians who erroneously concluded that they were burned out and quit their jobs or who were retrained in another specialty or retired from medicine completely only to find that they still felt unhappy, numb or fatigued because of an unrecognized mood disorder,” they wrote.
Stories from physician residents
Doctors today
The most recent Canadian data on physicians and anxiety appears to indicate that it’s a bigger problem for medical learners than physicians who’ve jumped over the hurdles of training and are now in practice.
The CMA’s 2025 National Physician Health Survey asked about what level of anxiety practising physicians and medical residents are dealing with, and compared them with its 2021 survey. Residents seem to be having a rougher time with anxiety in particular. Up by two percentage points, 14% of residents reported “severe” anxiety in 2025, with 17% reporting “moderate” levels (36% said “mild” and 32% said “minimal”). Fewer practising physicians reported “severe” anxiety (8% down from 10%) between the two surveys—and held a solid lead (51%) on reporting “minimal” anxiety. These respondents were questioned using the general anxiety disorder seven-item scale, rather than using the word anxiety more colloquially.
Accommodation
Whether framing anxiety as a disability, a chronic illness or otherwise, the move to accommodate these challenges is picking up speed.
“I think there’s increasing acceptance of the fact that there is so much entrenched ableism in the profession and that manifests, of course, in how we design schools and educational systems,” said Dr. Pamela Liao, a family physician and interim associate dean for accessibility and disability health at the School of Medicine at Toronto Metropolitan University. “There’s been a growing, emerging voice and advocacy and physicians are starting to gather and speak on these things, which historically has, frankly, never happened.”
Dr. Liao says learners leaving their “pre-medical life,” are naturally going to experience new stressors. And with that, long-standing coping strategies may no longer be sufficient; or new symptoms may appear for the first time.
Medical education itself needs to help future doctors understand the reality of living with disability or chronic disease, not just for patients, but themselves, she says. “I get this question a lot: Can person X with Y diagnosis be a doctor? And I think: You can admit 100 extremely healthy medical students (but) . . . we can’t prophylax all of them against every disease we all know about.”
In any illness, effects can wax and wane and, “It applies to anxiety just as much as MS. A lot of these principles are the same,” she noted. Indeed, “there’s no cookie cutter formula,” and accommodation needs to take into account whether a student is treating their anxiety or not, how they might be doing so and what the school can provide them that would genuinely help.
Labels and stigma
Research from 2025 looking at second-year American medical students found higher rates of burnout among those who reported uncertainty about whether they had a disability. Multiple factors play in, such as not knowing if they fit a specific legal definition or the parameters of their given institution. Plus, there are “both academic and stigma-related concerns that discourage self-identification. Personal factors—such as identity development, worries about the implications of disclosure in a high-stakes environment, questioning whether one’s experiences are ‘severe enough’ to qualify as a disability, and discomfort with the term ‘disability’ fueled by societal ableist perceptions—may also contribute.”
Another analysis examined 674 responses from students in the 2019 and 2020 Association of American Medical Colleges year-two questionnaire. These first-person anecdotes from medical learners with a disability highlight successes and failures when it comes to accommodating mental health—all underlining the real impact an institution’s attitude can have on learner achievement and wellbeing.
“(My school) provides free of charge, unlimited access to a psychiatrist and therapist. This has been incredibly helpful in keeping me healthy. All schools should provide free of charge mental health services to learners,” wrote one learner in 2019.
Another learner noted the presence of support was helpful even though they had yet to make use of what their school offers, writing, “I know how to access these resources if my normal compensatory mechanisms are not enough to continue my academic success.”
Others articulated worries over private health information being disclosed through unsecure channels, while another succinctly underlines a classic concern: “I was led to believe that requesting accommodations in medical school could be used against me in the future during my career.”
The pain of a secret
Disclosure of mental health conditions is always a balancing act between patient safety and physician privacy.
Licensure applications are a key hurdle for physicians wrapping up their medical training and moving into practice. And it’s at this moment when disclosure of mental health challenges can itself become anxiety-inducing. A 2023 analysis published in CMAJ examines the issue of how various jurisdictions ask about these sensitive topics. It compiled the guidance provided by both international and Canadian sources on how these questions should be framed on licensure applications. The guidance says applications should ask only about current impairment, and not the presence of the illness itself, past impairment or treatment the physician may be currently seeking for the illness. Applications should also not distinguish between mental and physical health—or at least ask about these issues in similar ways. Applications should also normalize seeking help for conditions and define what “negative impact” from impairments actually means. Of the specific applications the researchers looked at, 77% didn’t follow this guidance.
Newfoundland was the only province adhering to the consensus-based guidance, with its question: “Do you have a physical, cognitive, and/or mental health issue which may reasonably pose a risk of harm to patients?”
Compare that with British Columbia’s much broader question: “Have you ever had, or been advised by a healthcare professional that you have had a physical, cognitive or mental health condition that, were it to recur, would be reasonably likely to negatively impact your medical practice in the future?”
Questions like these at such a critical juncture are powerful and, “may pose barriers to disclosure and help-seeking for physicians with medical conditions and can lead to negative impacts on both physician health and patient care,” the authors emphasized.
