One in four Canadian physicians suffers from burnout, according to a survey of the profession.

Released on Wednesday, the poll by the Canadian Medical Association also shows significant rates of depression and suicidal ideation (thoughts) among the nation’s doctors.

“To see these results reported is alarming,” said CMA president Dr. Gigi Osler, warning that poor physician health can impact patient care.

Residents, or doctors in training, along with female physicians report the highest rates of problems, according to the CMA National Physician Health Survey: A National Snapshot.

The findings are consistent with those reported in other jurisdictions and are being made public the day before 500 people — mostly doctors — from around the world gather in Toronto for the International Conference on Physician Health. The conference is held every two years and is organized by the Canadian, American, and British Medical Associations.

The CMA represents Canada’s 85,000 doctors, residents and medical students.

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The CMA survey was conducted online last year with almost 3,000 physicians and residents. It is the first time a study of this extent has been done on the Canadian medical workforce and will serve as a baseline for future research.

According to the findings, one in three Canadian physicians screens positive for depression.

To assess participants for suicidal ideation, they were asked if they had thought about taking their own lives. Nineteen per cent responded that they had done so within their lifetime and 8 per cent reported doing so in the last year.

Osler said what strikes her most about the findings is the large number of doctors reporting both high levels of resilience and burnout.

Some 82 per cent reported being highly resilient, or able to bounce back from hardships.

Osler said that tells her physicians are doing well when it comes to personal self-care but are encountering trouble when it comes to external factors such as workplace pressures.

“The complexity of medicine is changing,” she said.

Patients are getting older and have more complex medical problems, and physicians have more therapeutic options to choose from, she noted.

There is more administration, bureaucracy and paperwork, and at the same time health-care resources are decreasing, Osler continued.

“High workload, high stress and low resources,” are a recipe for burnout, she said. “We need to start focusing on change in the system because physician health has to be a shared responsibility.”

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The survey found that residents have a 48 per cent increase in odds of experiencing burnout, a 95 per cent increase in odds of depression and a 72 per cent increase in odds of suicidal ideation at some point in their lives compared to other physician groups.

Osler said contributing factors include low workplace control, school-to work transitioning, and ongoing examinations and tests.

For women physicians, the survey found a 23 per cent increase in odds of experiencing burnout, a 32 per cent increase in odds of depression and a 31 per cent increase in odds of lifetime suicidal ideation compared to their male colleagues.

Osler noted that even outside medicine, women report higher levels of exhaustion and greater domestic responsibilies, for example, child care.

The survey found more than 80 per cent of respondents are aware of health programs tailored specifically to physicians, but only 15 per cent take advantage of them. Reasons for not accessing them include not being aware of them, believing their problems were not severe enough and being ashamed to seek help.

A 2016 article in the CMAJ stated that medicine has the highest rate of suicide of any profession.

Osler said more research on this is required.

Dr. Murray Erlich, 57, of Toronto said burnout is what caused him to make a slight change in his career trajectory a year ago.

He went from practising psychiatry to becoming a certified life coach and many of his clients are physicians and residents experiencing burnout.

With much first-hand experience on the subject, he said there is a stigma in the profession that deters some from seeking help.

It is linked to a long-standing culture that sends a message to doctors to show confidence and hide vulnerability, Erlich said.

But there is a growing awareness of the problem, even in medical schools, which today include a focus on physician health, he noted.