Modlin David M, Aranda Marcos C, Caddell Erin C, Faler Byron J
Dwight D Eisenhower Army Medical Center, Department of Surgery, Fort Gordon, Georgia.
Dwight D Eisenhower Army Medical Center, Department of Surgery, Fort Gordon, Georgia.
J Surg Educ. 2020 Sep-Oct;77(5):1046-1055. doi: 10.1016/j.jsurg.2020.03.002. Epub 2020 Mar 25.
Resident burnout is an increasing issue in graduate medical education programs. Military graduate medical education is unique in numerous ways and may have different rates of burnout as well as different causes. This study aims to assess resident burnout rates and contributing factors among military general surgery residents.
DESIGN, SETTING, AND PARTICIPANTS: Using Department of Defense approved software, an anonymous survey was created and distributed to all general surgery residents (n = 180) in 6 US medical centers where there are general surgery residency programs. The survey contained an Abbreviated Maslach Burnout Index questionnaire, multiple choice questions including several military-specific questions, and 2 open ended questions. Rates of burnout and potential risk factors associated with burnout were analyzed.
After the collection period, 92 of 180 (51%) residents completed all Abbreviated Maslach Burnout Index questions, demographics, and military specific questions with an opportunity for written comments. Notable demographic findings of the respondents were that 64% were male, 65% were married or engaged, 40% had children, and 69% had no student loan debt. Overall, there was a 66% rate of burnout in any tertile. Variables found to be significant for overall burnout included the likelihood the resident plans to stay beyond their active duty service obligation and the perceived level of autonomy. Of the written responses, the most commonly cited contributing factor was the work burden from nonclinical and/or administrative tasks while the most common protective factor was resident camaraderie.
Overall, burnout rates are similar among military general surgery residents compared to published reports of civilians. The close association with resident burnout and anticipation of early withdrawal from military service demonstrates this topic is potentially important to retention of the military medical force. The topics of increased resident autonomy, decreased non-clinical duties, and efforts to increase resident camaraderie should be more closely evaluated.
住院医师职业倦怠是毕业后医学教育项目中日益突出的问题。军队毕业后医学教育在诸多方面独具特色,其职业倦怠率及成因可能也有所不同。本研究旨在评估军队普通外科住院医师的职业倦怠率及相关影响因素。
设计、地点与参与者:利用国防部批准的软件,设计了一份匿名调查问卷,并分发给美国6家设有普通外科住院医师培训项目的医学中心的所有普通外科住院医师(n = 180)。该调查问卷包含一份简化版的马氏职业倦怠量表问卷、多项选择题(包括一些与军队相关的问题)以及2个开放式问题。分析职业倦怠率及与职业倦怠相关的潜在风险因素。
在收集期结束后,180名住院医师中有92名(51%)完成了所有简化版马氏职业倦怠量表问题、人口统计学问题及与军队相关的问题,并提供了书面评论的机会。受访者显著的人口统计学特征为:64%为男性,65%已婚或订婚,40%育有子女,69%无学生贷款债务。总体而言,任何三分位数中的职业倦怠率均为66%。发现对总体职业倦怠有显著影响的变量包括住院医师计划在现役服务义务期后继续留任的可能性以及感知到的自主程度。在书面回复中,最常提及的促成因素是非临床和/或行政任务带来的工作负担,而最常见的保护因素是住院医师之间的情谊。
总体而言,与已发表的平民报告相比,军队普通外科住院医师的职业倦怠率相似。职业倦怠与预期提前退出军队服役之间的密切关联表明,这一话题对保留军队医疗力量可能具有重要意义。应更密切地评估增加住院医师自主权、减少非临床职责以及增进住院医师情谊等议题。