美国医学生、住院医师和早期职业医生与美国普通人群相比的倦怠情况。

Burnout among U.S. medical students, residents, and early career physicians relative to the general U.S. population.

机构信息

Dr. Dyrbye is associate professor of medicine, Division of Primary Care Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota. Dr. West is associate professor of medicine and biostatistics, Division of General Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota. Mr. Satele is statistician in Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota. Dr. Boone was with the American Medical Association, Chicago, Illinois, at the time this study was conducted and is with the University of Illinois, Chicago, Chicago, Illinois, now. Dr. Tan was with the American Medical Association, Chicago, Illinois, at the time this study was conducted and is chief strategy officer, Immunization Action Coalition, St. Paul, Minnesota, now. Dr. Sloan is professor of biostatistics and oncology, Health Sciences Research, Mayo Clinic, Rochester, Minnesota. Dr. Shanafelt is professor of medicine, Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, Minnesota.

出版信息

Acad Med. 2014 Mar;89(3):443-51. doi: 10.1097/ACM.0000000000000134.

DOI:10.1097/ACM.0000000000000134

PMID:24448053

Abstract

PURPOSE

To compare the prevalence of burnout and other forms of distress across career stages and the experiences of trainees and early career (EC) physicians versus those of similarly aged college graduates pursuing other careers.

METHOD

In 2011 and 2012, the authors conducted a national survey of medical students, residents/fellows, and EC physicians (≤ 5 years in practice) and of a probability-based sample of the general U.S. population. All surveys assessed burnout, symptoms of depression and suicidal ideation, quality of life, and fatigue.

RESULTS

Response rates were 35.2% (4,402/12,500) for medical students, 22.5% (1,701/7,560) for residents/fellows, and 26.7% (7,288/27,276) for EC physicians. In multivariate models that controlled for relationship status, sex, age, and career stage, being a resident/fellow was associated with increased odds of burnout and being a medical student with increased odds of depressive symptoms, whereas EC physicians had the lowest odds of high fatigue. Compared with the population control samples, medical students, residents/fellows, and EC physicians were more likely to be burned out (all P < .0001). Medical students and residents/fellows were more likely to exhibit symptoms of depression than the population control samples (both P < .0001) but not more likely to have experienced recent suicidal ideation.

CONCLUSIONS

Training appears to be the peak time for distress among physicians, but differences in the prevalence of burnout, depressive symptoms, and recent suicidal ideation are relatively small. At each stage, burnout is more prevalent among physicians than among their peers in the U.S. population.

摘要

目的

比较职业阶段的倦怠和其他形式的困扰的患病率，以及受训者和早期职业（EC）医生的经历与从事其他职业的同龄大学毕业生的经历。

方法

在 2011 年和 2012 年，作者对医学生、住院医师/研究员和 EC 医生（≤5 年实践经验）以及美国普通人群的概率样本进行了全国性调查。所有调查都评估了倦怠、抑郁症状和自杀意念、生活质量和疲劳。

结果

医学生的回复率为 35.2%（4402/12500），住院医师/研究员为 22.5%（1701/7560），EC 医生为 26.7%（7288/27276）。在控制了关系状况、性别、年龄和职业阶段的多变量模型中，作为住院医师/研究员与倦怠的几率增加相关，而作为医学生则与抑郁症状的几率增加相关，而 EC 医生则具有最低的高疲劳几率。与人口对照样本相比，医学生、住院医师/研究员和 EC 医生更有可能出现倦怠（均 P <.0001）。医学生和住院医师/研究员比人口对照样本更有可能出现抑郁症状（均 P <.0001），但没有更有可能经历过近期自杀意念。