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Burnout of Young Doctors Affects Careers, Recruiting and Patient Care

PHILADELPHIA - (March 5, 2002) Four papers in the March 5 Annals of Internal Medicine explore the causes and consequences of medical resident "burnout." Residents are doctors enrolled in postgraduate training after receiving their medical degrees.

A study of 115 residents in one internal medicine residency program found that 76 percent suffered from a syndrome defined as "burnout" (emotional exhaustion, depersonalization, and a sense of low accomplishment) (Article, p. 358). Of these, half were depressed and nine percent misused alcohol. Residents suffering from burnout were less satisfied with their careers than unaffected residents. They reported giving suboptimal patient care at least once a month.

Another article in the March 5 Annals reported the results of a survey of residents in all 415 internal medicine residency programs in the United States (Perspective, p. 384). About 4,130 residents returned information on financial, emotional and work-related issues. Education-related debt was high: 42 percent had debt of at least $50,000 and 19 percent had debt of at least $100,000. Forty three percent of the resident respondents had a monthly disposable income of $100 or less, and 16 percent said they couldn't afford safe housing.

Despite an 80 hour work week during residency, 33 percent did medical work outside their training (moonlighting); 349 doctors reporting working more than 20 hours a week at their moonlighting jobs. Residents with heavy education-related debts were more likely to moonlight.

Thirty-five percent of the residents in this study reported four or five symptoms of depression, a figure higher than estimates for the adult U.S. population. Sixty-one percent of the residents reported becoming more cynical as they progressed through residency. The authors of this article say that "the unique mental health needs of many female medicine residents are not being met."

To ease financial burdens, the authors suggest tuition subsidies for medical education, higher salaries for residents, full deferral of repayment of the principal and interest on education-related loans without interest accrual during residency training, and better financial advising for residents. They say that the medical community must respond "immediately and effectively" to the "alarming financial and psychological distress" expressed by many of trainees.

Two editorials provide further perspective on the emotional and financial pressures of medical residency burnout. One editorial calls for medical educators to help residents "reflect, plan, arrange, chose and demand a whole life"… not just excellence in their profession (Editorial, p. 391). Another editorial notes that the average educational debt for medical students (not yet residents) who graduated in 2001 was nearly $100,000 (Editorial, p. 394).

Annals of Internal Medicine is published by the American College of Physicians-American Society of Internal Medicine (ACP-ASIM), the nation's largest medical specialty organization and its second-largest physician group.

Contact: Susan C. Anderson, 215-351-2653 or 800-523-1546, ext. 2653

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