Physician burnout and career regret prevalent in residents

By Bianca Nogrady
Almost half of resident phy­sicians show signs of burnout, and more than one in 10 have regret over their career choice, researchers have found.

Two studies, published in JAMA, have explored the issue of physician burnout, finding it is not only highly prevalent but also not well defined.

The first study – a prospective cohort study in 3588 US resi­dent physicians – found 45.2% of 3574 respondents reported experiencing at least one symptom of burnout weekly.

Emotional exhaustion was the most common symptom, reported by 35.6% resident physicians weekly, followed by depersonalisation (34.9%). One-quarter of respondents reported high emotional exhaustion and high depersonalisation at least weekly. 

Residents training in urology, neurology, emergency medicine and general surgery showed even higher relative risks of burn­out symptoms than those training in internal medicine, whereas dermatology and pathol­ogy showed lower risks of burnout.

Women were at greater risk of burnout symptoms than men, as were individuals with higher anxiety scores during medical school. However, those scoring more highly on empathy at medical school had a lower risk of burnout during residency.

Overall 14.1% of resident physicians regretted their career choice, saying they would defi­nitely not or probably not choose to become a physician again. 

The second study, a syste­ma­tic review of 182 studies of phy­sician burnout, found at least 142 unique definitions for burnout, 47 distinct defi­ni­tions of overall burnout prevalence and 29, 26, and 26 definitions of emotional exhaustion, depersonalisation and low personal accomplish­ment, respectively.

The overall prevalence of burnout in these studies ranged from 0% to 80.5%, and the prevalence of different burnout symptoms varied wildly.

Commenting on the findings, Professor Garry Walter, Medical Director of the Doctors’ Health Advisory Service (DHAS) NSW/ACT, said they highlighted that while medicine was a rewarding profession, it could also be arduous. 

‘The finding in the pros­pec­tive cohort study that almost half of resident physicians – that is, residents at an early career stage – reported burnout is alarming, and should galvanise efforts to, firstly, identify those at risk and, secondly, address the factors that may contribute to burnout,’ Professor Walter said.

He said the US data likely reflected the situation in Australia, and therefore pointed to a need for medical students, doctors, medical colleges and medical associations to all be aware of stressors. It also reinforced the importance of specialised services for doctor’s health, such as the DHAS, he said.
JAMA 2018; 320: 1114-1130.
JAMA 2018; 320: 1131-1150.