Some specialties of doctors more hardened than others

A longitudinal study tracking medical school students through residency suggests that the exhausting process leaves many young physicians questioning their career choices.

Resident physicians focusing on certain specialties are particularly prone to burnout, according to a study conducted by the Mayo Clinic.

The longitudinal study, published this month in JAMA, found that 45% of second-year medical residents reported having at least one symptom of burnout, which may include exhaustion and depersonalization of patients.

Residents in urology, neurology, emergency medicine and general surgery were the most at risk of burnout, but study authors do not know why.

"It's a great question for a separate research study," says Liselotte Dyrbye, MD, a researcher from the Mayo Clinic and the first author of the article.

"We know that at the beginning of the medical school, there is not a lot of burnout." But even in medical school, burnout develops after a few years. It starts early and continues to train. "

This year-long study, involving 50 medical schools and 3,600 medical trainees, is the first national study to track medical students in early residency studies to track the predictors of burnout.

Residents were asked about their specialty, ethnicity, student debt, and other demographics, and responded to surveys designed to measure anxiety, emotional social support, and social security. Empathy and burnout. The survey found that residents suffering from burnout were three times more likely to regret becoming a doctor.

Dyrbye says that she can only speculate on why some specialties are more prone to exhaustion, but she's spotted a trend.

"We are seeing high rates of burnout among resident physicians in urology, neurology, urinary surgery and general surgery, which reflects our previous findings of physicians in practice that we conducted with WADA a few years ago. .

"There may be something unique in particular work environments related to workload, effectiveness of practice, autonomy, control, the ability to work, and the ability to work. balance between work and private life, "she says. "Another possibility could be that the supervising doctors that impact the learning environment so that these trainees are affected and at increased risk of burnout."

"Perhaps there is more harassment or denigration in these specialized training programs compared to other specialized training programs, which probably reflects more the environment of the practice", she says. "When a supervising physician works in the same practice environment as the resident, it's not really surprising that they both experience work-related stress that leads to burnout." . "

In an interesting ride, the study found that students from self-identified minorities were more likely to regret their specialty choices, and the authors of the study suggest that one of the reasons might be that these minority physicians programs.

"There are many initiatives in academic medical centers across the country to really enhance diversity, because it improves science, patient care and research," says Dyrbye. "As a result, all diversity committees look at retention and recruitment, as well as various issues, and people from diverse backgrounds become overburdened when they are invited to join these committees. I am worried about not being patted on the shoulder.

"There is nothing else that comes out of this resident's plate to accommodate this institutional service," says Dyrbye. "We think it could be a little too much for these residents, it could contribute to some of their regrets of specialty choices."

Dyrbye takes some comfort knowing that, given the rigors of physician training, more than 50% of those surveyed said they were happy.

"But we should be concerned about the prevalence of burnout, that should not be so high," she says. "We know that burnout is associated with suboptimal patient care. If these resident physicians continue to experience symptoms of burnout, they are also more likely to drop out or not see so many patients, which affects our access to care.