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Scientists team up to explore the development of burnout in medical trainees and practising physicians

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A new collaboration between CHÉOS Scientist Dr. Peter Dodek and Dr. Elaine Cheung of Northwestern University in Chicago aims to understand burnout in medical students, residents, and practising physicians and potential strategies to prevent it.

Burnout is a syndrome resulting from chronic workplace stress and was recently recognized in the World Health Organization’s International Classification of Diseases (ICD) following recommendations from international health experts. The ICD describes burnout as characterized by: 1) feelings of energy depletion or exhaustion; 2) increased mental distance from one’s job, or feelings of negativism or cynicism related to one’s job; and 3) reduced professional efficacy.

Burnout is common among medical professionals, including physicians, and results in increased chances of leaving the profession. Burnout can also negatively impact safety and quality of care for patients.
One of Drs. Dodek and Cheung’s current collaborations focuses on burnout during the earliest stages medical practice: medical school.

Dr. Peter Dodek

One project in this collaboration looks at the coping strategies used by medical students at UBC to understand which are effective and which may be doing more harm than good. Dr. Dodek and UBC medical student/researcher Anna Culjak presented preliminary results for this project at the recent American Thoracic Society International Conference in Dallas.

“Trainees use a number of strategies to deal with the stresses of medical school—some are active and social (e.g., taking action to try to make the situation better, getting advice from others), and others are avoidant (e.g., denial, substance use),” noted Dr. Dodek. “We’ve found that avoidant coping strategies are associated with higher prevalence of burnout and lower measures of resilience; this finding could help to identify who might benefit from interventions to limit or prevent burnout.”

“In general, medical students exhibit a high prevalence of burnout, up to 60% in 3rd year,” said Dr. Dodek. “This is despite experiencing low levels of moral distress, a type of intense stress that can lead to burnout.”
Moral distress refers to feelings of anger, frustration, guilt, and powerlessness that health care professionals experience when they are unable to practice according to their own ethical standards.This type of stress may result from factors such as work culture, leadership issues, poor communication, organizational policy, and financial constraints.

Dr. Elaine Cheung

Dr. Dodek has been investigating different aspects of and interventions for moral distress for several years. However, most of the current research in the area has looked at burnout and moral distress cross-sectionally, meaning that a ’snapshot‘ is taken at one time point, making it difficult to assess how these outcomes change over time.

In order to better understand the development of burnout and moral distress, Drs. Dodek and Cheung are conducting a longitudinal study of medical residents in different specialties.

“Being able to follow residents over time will allow us to identify other factors related to burnout risk, such as demographic factors, specialty, specific rotations, or stage of training, ultimately allowing us to contribute to preventing and limiting the harmful effects of burnout and improving physician wellbeing” explained Dr. Cheung.

Relating to her collaborative projects with Dr. Dodek, Dr. Cheung will be a visiting professor at CHÉOS later this month and will be presenting at the upcoming Work in Progress Seminar (June 19) about a similar project in surgical residents in the U.S.

Dr. Elaine Cheung is Research Assistant Professor in the Department of Medical Social Sciences at Northwestern University’s Feinberg School of Medicine. Her program of research investigates the factors that promote psychological adjustment in the context of serious life stress, and the development of burnout prevention interventions for physicians and medical trainees.