Happy medical residents are all alike. Every unhappy resident would take a long time to count.

It’s no secret that medical training is grueling: long hours, little sleep, rigid hierarchies, steep learning curves. It’s unfortunate but not surprising, then, that nearly one-third of residents experience symptoms of depression, and more than 10 percent of medical students report having suicidal thoughts. But is it worse for women than men?

A new study in JAMA Internal Medicine suggests yes. Dr. Constance Guille and colleagues analyzed the mental health of more than 3,100 newly minted doctors at 44 hospitals across the country. Before starting residency, men and women had similar levels of depressive symptoms. After six months on the job, both genders experienced a sharp rise in depression scores — but the effect was much more pronounced for women. A major reason: work-family conflict, which accounted for more than a third of the disparity.

Despite large increases in the number of women in medicine, female physicians continue to shoulder the bulk of household and child care duties. This unequal distribution of domestic labor is not unique to medicine, of course, but its manifestations are particularly acute in a physically and emotionally demanding profession with a lengthy training process that allows few, if any, breaks.

Image Despite large increases in the number of women in medicine, female physicians continue to shoulder the bulk of household and child care duties. Credit... Karen Bleier/Agence France-Presse — Getty Images

The structure of medical training has changed little since the 1960s, when almost all residents were men with few household duties. Support for those trying to balance home and work life hasn’t kept pace with changing demographics, nor has the division of domestic labor shifted to reflect the rise of women in the medical work force. Today, women account for more than one-third of practicing physicians and about half of physicians-in-training. In 1966, only 7 percent of graduating medical students were women.