Mind and Body: Residency Programs Tackle Burnout

Integrative Programs Strive to Bring Balance to Stressful Lives

Nancy A. Melville


August 20, 2015

In This Article

Physical Exercise in Residency More of an Uphill Battle

Meanwhile, maintaining enough routine exercise for good health may present much more of a challenge than reflective writing when it comes to constrained resident schedules, according to the results of one study describing physical activity and burnout levels among residents. The study, published in the Journal of Graduate Medical Education, showed that among 76 internal medicine residents at the University of Minnesota and Hennepin County Medical Center in Minneapolis who completed surveys on burnout and physical exercise, only 40.8% reported achieving US Department of Health and Human Services physical activity guidelines, and as many as 78.9% reported decreases in their levels of physical activity since they had started medical training.

More than one half (53.9%) of the residents were determined to have burnout, as measured according to the Maslach Burnout Inventory-Human Services Survey. Of note, residents who were able to meet physical activity guidelines were much less likely to be burned out than their fellow residents (odds ratio, 0.38; 95% confidence interval, 0.147-0.99).

"Among internal medicine resident physicians, achievement of national physical activity guidelines appears to be inversely associated with burnout," coauthor Shawn M. Olson, MD, MPH, assistant residency director of HealthPartners/University of Minnesota Occupational and Environmental Medicine Residency, told Medscape Medical News. "To our knowledge, this is the first study specifically assessing the association between physical activity and burnout in residents."

That's important—and surprising, Dr Olson said, owing to the known role of physical activity in reducing stress. "Although physical activity has been suggested as a potential viable intervention for prophylaxis or treatment of burnout in residents in other studies, investigation into this topic has received relatively sparse attention," he said.

The study, though small, could represent a snapshot of much broader patterns among residents across specialties, Dr Olson suggested. "Our study was performed on a very small scale, with internal medicine residents specifically; therefore, the generalizability of our results is limited. However, further investigation is merited, as we hypothesize that this effect may be apparent in residents from many medical specialties. Given the high national prevalence of burnout and inactivity, the protective properties of physical activity merit further study and should be communicated to residents and residencies in an effort to reduce burnout."

Burnout an Epidemic; Highest Rates Seen in Surgery

Judging from the results of a recent survey from the University of North Carolina, presented at the annual meeting of the American Psychiatric Association and reported by Medscape Medical News, the problem of burnout does indeed pervade most specialties, reaching epidemic levels. However, some specialties have a much higher degree of burnout than others.

According to the survey, overall, as many as 70% of residents met criteria for burnout. In looking at rates according to specialty, general surgery had the highest burnout rates (89%), followed by radiology (85%), surgical subspecialties (82%), anesthesiology (81%), and internal medicine (79%). Specialties with the lowest rates were pediatrics (53%), family medicine (50%), and pathology (46%).

Topping the list of factors residents that felt contributed to their burnout was the lack of time to exercise, take care of oneself, and engage in enjoyable activities outside of work. "Anything we can do to help residents achieve a work-life balance is going to be beneficial," Dr Holmes said in that article. "It might be something as simple as putting a gym in the hospital, where residents can work out instead of trying to fit that into their schedule after they go home."

Drs Zisook, Parsi, and Olson had no disclosures to report. Dr Brennan reported that her research received a grant from the University of Toledo's Academy of Educators.


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