A new study reveals that being a doctor may be even more difficult than you think. According to a report from the Washington Post, an international study released on Tuesday reveals that almost one-third of doctors who are just starting out their careers screened positive for depression, or exhibited symptoms of depression.

The study, published in JAMA, found that depression was much more common in medical professionals than in the general public. It suggests that the years of interning and residency immediately following medical school can take a serious emotional toll. These times are characterized by long hours, heavy responsibility towards patients, and intense training. To make matters worse, new doctors are often the lowest on the totem pole, and thus are more likely to feel unappreciated.

The study examined more than 50 years of peer-reviewed studies that tracked depression symptoms for medical students around the world. The results suggest that the percentage of medical residents who showed signs of depression ranged from 20 to 43 percent. After controlling for various factors, the average percentage of new medical professionals that exhibited signs of depression was about 29 percent.

Compared to the general population, medical professionals have a much harder time wrestling with depression. According to a study from the National Institute of Mental Health released in 2013, only 6.7 percent of American adults reported having at least one major depressive event during the previous year.

The study was led by Dr. Douglas Mata, a resident in pathology at Brigham and Women’s Hospital in Boston and Srijan Sen, a psychiatrist specializing in physician mental health from the University of Michigan’s Medical School.

The study found that many of the doctors examined fell short of qualifying as a major depressive patient, but the number of doctors that showed signs of depression was significantly higher than the general population.

“You can have significant symptoms that are just as debilitating even if you don’t meet all the criteria,” Mata said.

A press release from the JAMA Network Journals outlining the details of the study can be found here.