Scores on the Patient Health Questionnaire 9-item version (PHQ-9) were assessed at baseline (1 to 2 months before the start of the internship) and then quarterly throughout the internship year. On the PHQ-9, depression is categorized as minimal by a score of 0 to 4, mild by a score of 5 to 9, moderate by a score of 10 to 14, moderately severe by a score of 15 to 19, and severe by a score of 20 to 27. The widths of the 95% confidence intervals (I bars) have not been adjusted for multiplicity and may not be used in place of hypothesis testing. The analysis was adjusted for the baseline factors of sex, surgical or nonsurgical specialty, personality trait of neuroticism, history of depression before the internship, early family environment, age, cohort calendar year, marital status, parental status, and time-varying factors of stressful life events and medical errors (see the Supplementary Appendix for details of measures).