Department of Medicine, University of Miami Leonard M. Miller School of Medicine, 1600 NW 10th Avenue, Suite 1124, Miami, Florida, 33136, USA.
Department of Community and Family Medicine, University of Miami Leonard M. Miller School of Medicine, Miami, Florida, USA.
BMC Med Educ. 2022 Jan 29;22(1):69. doi: 10.1186/s12909-022-03135-x.
International medical graduates (IMGs) have less burnout than U. S. medical school graduates (USMGs) during residency training. This study evaluates possible correlates of differences in burnout rates between USMGs and IMGs.
We surveyed 375 first-year residents at orientation in June/July 2017. We assessed burnout using the Copenhagen Burnout Inventory (CBI) and used validated scales to measure stress, quality of life (QoL), mastery, and spirituality. We collected data on gender, place of graduation, language fluency, and specialty. We compared CBI scores between USMGs and IMGs, performed a multivariate linear regression analysis of relationships between covariates and CBI subscales, and logistic regression analysis for our categorical definition of burnout.
Two hundred twenty-two residents responded for a response rate of 59%. Personal, work or patient- related burnout was common among residents, particularly among USMGs. The most common form of burnout was work-related. Forty nine percent of USMGs have work burnout compared to 26% of IMGs (p < 0.01). In multivariate analysis, being an IMG reduced odds of work-related and of total burnout by 50% (OR 0.5 C.I 0.25-0.99). Perceived mastery was associated with reductions in all subscales of burnout (p < 0.05). Stress and low QoL related to personal and work burnout scores (p < 0.01).
Work-related burnout is more common among USMGs than in IMGs. Although mastery, QoL and stress were correlates of burnout among all residents, these factors did not explain the difference. Future studies should evaluate the role of medical school structure and curriculum on differences in burnout rates between the two groups.
在住院医师培训期间，国际医学毕业生（IMGs）的倦怠程度低于美国医学院毕业生（USMGs）。本研究评估了 USMGs 和 IMGs 之间倦怠率差异的可能相关因素。
我们在 2017 年 6 月/7 月的迎新时调查了 375 名一年级住院医师。我们使用哥本哈根倦怠量表（CBI）评估倦怠程度，并使用经过验证的量表测量压力、生活质量（QoL）、掌握感和灵性。我们收集了性别、毕业地点、语言流利程度和专业的数据。我们比较了 USMGs 和 IMGs 的 CBI 评分，对 CBI 子量表与协变量之间的关系进行了多元线性回归分析，并对我们倦怠的分类定义进行了逻辑回归分析。
222 名居民做出了回应，回应率为 59%。居民中个人、工作或患者相关的倦怠很常见，尤其是 USMGs。最常见的倦怠形式是与工作相关的。49%的 USMGs 存在工作倦怠，而 IMGs 中只有 26%（p<0.01）。在多变量分析中，作为 IMG 使与工作相关和总倦怠相关的几率降低了 50%（OR 0.5，95%CI 0.25-0.99）。感知掌握感与所有倦怠子量表的降低相关（p<0.05）。压力和低生活质量与个人和工作倦怠评分相关（p<0.01）。
与 IMGs 相比，USMGs 中与工作相关的倦怠更为常见。尽管掌握感、生活质量和压力是所有居民倦怠的相关因素，但这些因素并不能解释差异。未来的研究应评估医学院结构和课程对两组之间倦怠率差异的作用。
