A cross-sectional complete enumeration postal survey was conducted to compare stress levels between specialist registrars (SpRs) in palliative medicine, clinical oncology and medical oncology. Four hundred and one UK-registered SpRs responded (response rate 63.1%). Levels of psychological distress and depression were measured by GHQ-12 and SCL-D: 102/390 (26.2%, 95% confidence interval (CI) = 21.8-30.5%)) scored > 3 on GHQ-12 indicating psychological distress, 44/391 (11.3%, 95% CI = 8.1-14.4%) scored > or = 1.5 on SCL-D indicative of depression. Suicidal ideation was indicated by 15 responders. There were no significant differences between specialties. The effect of stress on personal or family life was the dominant predictor of both psychological distress and depression, although dissatisfaction with choice of specialty and feeling underutilised also contributed. One in four SpRs experience stress. These results are similar to studies of general practitioner principals and consultants from other specialties. Stress needs to be managed if doctors are to survive professional life.