Which Burnout Recovery Works Best for Medical Trainees?

Ryan Syrek, MA

Disclosures

March 23, 2018

Not all burnout is created equal. At least, not according to new research in the Journal of Graduate Medical Education. In their qualitative study, Nauzley C. Abedini, MD, and colleagues sought to investigate the most critical factors that promoted recovery from burnout, as well as avoidance of future episodes, among residents and recent graduates.

The timing of a study on burnout recovery seems appropriate, as new research presented at the European Psychiatric Association 2018 Congress suggested that almost half of medical students experience the condition prior to residency. Combined with results of a new Medscape survey, which found that 42% of physicians feel burned out and 15% report depression, the need to identify successful approaches for prevention and remediation is increasingly obvious.

Although the study included trainees and younger doctors, the results from Abedini and colleagues are intended to have broader use. Among their most pertinent findings was that burnout takes at least two distinct categorical forms: "circumstantial" and "existential." Circumstantial burnout describes a reaction to environmental challenges or crises, whereas existential burnout is a more internalized struggle. As such, the forms react more strongly to recovery and prevention approaches targeted toward the specific underlying issues.

How to Recover From Circumstantial Burnout

Of the two forms, Abedini and colleagues suggest that circumstantial burnout is more likely to spontaneously resolve. That is to say, once the contributing environmental factors are no longer a continuing issue, burnout is likely to wane.

The study identified three themes that encouraged circumstantial burnout resolution: resolving workplace challenges, nurturing personal life, and taking time off. For residents, a change in rotation conditions often resulted in recovery. For others, encouraging a sense of security and safety in the face of personal stressors, such as financial difficulties, helped to mitigate the crisis. The most obvious solution, finding time away from medicine to relax or focus on personal concerns, was expectedly a strong contributor.

However, these recovery strategies were specific to circumstantial burnout. A commentary by Abigail Ford Winkel, MD, MHPE suggested that unlike circumstantial burnout, which may improve without direct intervention by methods such as taking a break or allowing time to pass, "existential burnout needs a more deliberate examination of meaning and professional place—even mental health services."

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