The antecedents and outcomes of feelings of job-related stress and personal achievement were studied in a large sample of consultant doctors working in Scotland. In a sample of 333 doctors it was found that a tendency to use emotion-oriented coping strategies and negative appraisals of organizational changes in the practice of medicine mediated the effect of the personality dimension of Neuroticism on reported job stress. Job stress levels predicted the degree of 'burnout' experienced by doctors, i.e. their tendencies to be emotionally exhausted by their work and to dehumanize patients. Higher clinical workloads were related to higher levels of stress but also to higher feelings of personal achievement. A substantial proportion of the variance in many of the variables in the stress model was accounted for by a general tendency to experience negative emotions, closely related to Neuroticism; this general factor appeared to be similar to the recently formulated concepts of 'negative affectivity' and 'somatopsychic distress'. The personality factors of Extraversion and Conscientiousness both contributed to positive feelings of personal achievement (N = 344); the effect of Extraversion was direct, whereas the effect of Conscientiousness was mediated by a tendency to use task-oriented coping strategies. Models of the processes of stress and personal achievement were tested for acceptability using the EQS Structural Equations Program. The implications of the models for transactional theories of stress are discussed.