I have a terrible confession. Despite reading volumes of journals that highlight the importance of doing work that is meaningful and interesting, I have never been able to truly understand why so many people are committed to becoming a doctor. It is not because the job doesn’t seem amazing; I completely appreciate that it is a fascinating role. Your skills add fundamental value to society – you literally save lives. However, it requires so many sacrifices both personally and financially, I am still humbled by the fact that so many people will do anything to make it their career.
The role is also characterised by unrelenting pressure, which is reflected in the recent finding by the General Medical Council’s (GMC’s) national survey that a quarter of doctors in training say that their job leaves them burnt out to a high or very high degree – up from 23.9 per cent in 2018. Despite some improvements in training, the stark findings from more than 75,000 doctors in training and their trainers show how much work is still to do to address the pressures on junior medical staff. This is an issue that is relevant globally with research by the Annals of Internal Medicine highlighting that doctors are burning out twice as fast as other workers and costing the US $4.6 billion each year.
Research has shown that work overload is one of the main causes of burnout. Burnout typically refers to a state of physical, mental, and emotional exhaustion. At work, it can be caused by multiple factors including, lack of control, work overload, insufficient reward, and a conflict of values. Research also shows certain personality types are more likely to experience burnout. For example, research on burnout and the Five Factor model found that people with high emotional stability experience less burnout (Alarcon, Eschleman & Bowling, 2009). The symptoms are primarily emotional, and can include disengagement, exhaustion, loss of motivation, feelings of helplessness, and depression.
So why is burnout such a key issue for doctors in training? To get to the bottom of this, I utilised my “Subject Matter Expert” on the topic, my significantly younger and smarter brother, who is currently training to be a doctor. Some of the key quotes were: “Ali, why are you talking to me in this silly voice? Can I carry on eating my breakfast now? Stop being weird!” On the actual topic in question, his reasoning for the higher levels of burnout in 2019 were due to “Shrinking budgets and the smaller numbers of training posts per team meaning that resources are being stretched across the health service. The increase in litigation has also compounded this with referrals to hospitals increasing and even greater pressure being placed on very inexperienced staff. Overall it is completely unsurprising how much burnout is being reported, it is a rewarding role but extremely challenging.“
At PSI we have done our own research on the topic of employee burnout. Specifically, we looked at the relationship between burnout on a range of factors including resilience. The purpose of this research was to identify whether there are any specific strategies that can help individuals deal with burnout more effectively. Results were collected using PSI’s Resilience Questionnaire™ and the Maslach Burnout Inventory – General Survey (Schaufeli, Leiter, Maslach & Jackson, 1996).
The results indicate that higher scores on the eight dimensions measured in The Resilience Questionnaire are associated with lower levels of burnout. Based on the study we found that individuals reporting lower levels of burnout tended to exhibit the following:
- More optimism about their life in general and belief that they will experience good outcomes (Optimism).
- More confident in their own ability to overcome challenges and obstacles (Self Belief).
- More confident in their ability to generate solutions and solve problems they encounter (Ingenuity).
- Clear goals that they are committed to achieving (Purposeful Direction).
These findings support previous research. For example, Chang, Rand, and Strunk (2000) found optimism to be a significant predictor of burnout at work. Additionally, setting goals (Purposeful Direction) can help employees to feel in control of their work which in turn can help prevent burnout, especially as a perceived lack of control over work and workload is one of the biggest predictors of burnout (Potter, 2005).
Based on this study, given that unfortunately scarce resources and smaller budgets are things that cannot be easily addressed by hospitals, it would be valuable for doctors in training to help develop some of these strategies and employ them in their day to day activities. Sometimes we cannot change our environment, but we can influence how we perceive it. Focusing on the positives, believing in our ability to get through difficult times, and focusing on our overarching goals should hopefully help us get through the challenges we face. Ultimately, having doctors who are healthy and able to deal with the pressure that they are subjected to, can only have a positive impact on themselves and the communities they serve. The power to reframe their thinking in these distinct areas can hopefully support them in the amazing work that they do.