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Doctors with Early Life Stress Found at Risk for Professional Challenges

Novel 4-year study identifies how childhood stress impacts career performance

October 31, 2014  |  

A study conducted by the UC San Diego Physician Assessment and Clinical Education program (PACE) found that childhood adversity could potentially play a role in a physician’s later professional relationships.

The findings were published online October 31 in General Hospital Psychiatry.

Although UC San Diego is the site for PACE, an education and quality improvement program for health care professionals, physicians from across the nation and representing different specialties were referred to and enrolled in the course that was part of the study.

“We wanted to wrap our heads around some of the reasons why certain physicians may have challenges maintaining professional boundaries,” said Kai MacDonald, MD, lead author of the study and associate physician in the Departments of Psychiatry and Family Medicine at UC San Diego School of Medicine. “Physicians are held to higher standards, so it’s critical they provide the highest quality of care with the utmost professionalism.”

The four-year study revealed that nearly two of three participating physicians reported having experienced a moderate or severe level of emotional neglect during childhood; one out of five described a moderate or severe level of overall childhood trauma and one-third said they had experienced another type of adversity, such as parental divorce or death.

“We were surprised at the prevalence of early life adversity encountered by the physicians in this study,” said MacDonald. “Through PACE, the physicians were able to develop insight into how the past can influence the present and discuss strategies to become more compassionate and respectful caregivers.”

Numerous studies have documented that childhood adversity can have a profound impact on the developing brain, affecting regions that regulate empathy, interpersonal closeness, decision-making and stress-regulation.

MacDonald noted that the study is the first to use a comprehensive, standardized questionnaire about early life stress and a written narrative autobiography. This combination, the researchers said, allowed participants to be more transparent with their life stories.

MacDonald and colleagues intend to do a follow-up study with a non-referred group of physicians to see if severe childhood stress is characteristic to physicians in general or particular within the group of doctors studied.

“We want to understand not only what could put a physician at risk, but also what makes caregivers resilient to childhood adversity,” said Andres F. Sciolla, MD, with UC San Diego School of Medicine and co-author of the PACE study. 

To learn more about the PACE program, please visit:

Co-authors include David Folsom, David Bazzo, Chris Searles, Christine Moutier, Michael L. Thomas, Katherine Borton and Bill Norcross, all at UC San Diego.

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Media contact: Michelle Brubaker, 619-543-6163,

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