Abstract:

Background: Burnout among medical residents and faculty has long been a problem. Burnout is defined as a high level of stress and a combination of emotional exhaustion, depersonalization, and a reduced sense of personal accomplishment. Burnout is particularly common among these professionals because of long duty-hours and the complexity of their jobs. Burnout can also negatively affect the quality of care for patients. Beginning in July 2011, new regulations on duty-hours limit first-year residents to a maximum of 16 hours per shift and a total of 80 hours per week. Previous duty-hour restrictions limited shifts to no more than 30 hours. These changes shift responsibilities away from first-year residents to other residents and faculty. We evaluated burnout rates for internal medicine faculty and residents and how they relate to a variety of demographic factors just prior to the implementation of new duty-hour restrictions.

Methods: All Wayne State University Internal Medicine faculty and residents were asked to complete a survey that included the Maslach Burnout Inventory–Health Services Survey (MBI-HSS). The MBI-HSS is considered the gold standard for evaluating burnout in healthcare professionals. Surveys were completed anonymously. Scores were calculated for each of the three categories: emotional exhaustion, depersonalization, and personal accomplishment and compared to normative data from the MBI-HSS medicine subscale. The survey included a variety of demographic questions such as age, gender, location of medical school, current level of training, daily commute time, daily time spent reading medical literature at home, and daily time spent using Electronic Medical Record (EMR) at home.

Results: 53 residents and 43 faculty members completed the survey. Overall, 45% (24/53) of residents and 23% (10/43) of faculty members were found to have burnout. Residents who graduated from US medical schools were more likely to have burnout than residents who graduated from international medical schools (60% vs 40%, p = .03). Participants that had burnout spent less time at home reading medical literature than compared to participants without burnout (24 min vs 40 min, p = .02) Other factors such as age, gender, level of training, daily commute time, and home EMR use were not found to significantly play a role in burnout rates.

Conclusions: Our study found that burnout continues to be a problem for residents and faculty. This study demonstrates that certain factors may play a larger role in causing burnout than others. For example, residents that graduated from a US medical school had a higher prevalence of burnout than graduates from international medical schools. There may be cultural, academic, and social issues that lead to these differences and which should be examined further. Also, our study found that participants who had burnout spent less time reading medical literature at home than participants without burnout. These disparities should be examined carefully to see if any policy changes can be made in order to curb resident and faculty burnout and improve patient care.

Keywords:

Burnout, internal medicine, residents, academic medicine.