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Every summer, more than 1,600 recent medical school graduates start training to become obstetrician-gynecologists at hospitals across the United States.

But even as they learn to do everything from screening women for cervical cancer and delivering babies to surgically removing ovarian cancer and uterine fibroids, one-third of them may develop clinical depression in their stressful first year of training, a study finds. The research is published in the American Journal of Obstetrics and Gynecology.

Yet only one-third of the OB-GYN first-year residents in the study sample who developed depression sought mental health help.

The findings suggest a need for more support during residency, the authors say, especially considering the national shortage of obstetricians and gynecologists and the additional work-life and public policy–related pressures faced by practitioners in the only surgical specialty predominantly made up of women.

In all, 88% of the first-year OB-GYN residents in the study were women, the same as the current U.S. resident population in that field. More than 1,270 of them completed standardized depression screening tests and other surveys before and during their first year of residency training, which is called the intern year.

The study was done as part of the Health Equity and Retention in Obstetrics and Gynecology, or HERO, Project, a national research effort focused on understanding the factors affecting the OB-GYN workforce. The HERO team hopes to identify ways to support physicians and keep them working in the specialty, which can ensure patients continue to have access to the care OB-GYNs can provide.

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