Resident Physician and Medical Academic Faculty Burnout

Physician burnout finds its roots in both undergraduate and graduate medical education and has emerged as an important cause of academic faculty turnover. Recognition of the need for resiliency training has led to the development and implementation of wellness programmes throughout the country and world. This chapter examines the causes and potential solutions of combating resident physician and academic faculty burnout in medical education. The authors reviewed current literature on wellness programmes in medical education, including both traditional and curricular approaches and provide a template for creating a well-rounded wellness programme to promote resident physician and academic faculty wellness.

Wellbeing as Defined by Resident Physicians: A Qualitative Study

The importance of resident wellbeing is increasingly recognized by the ACGME as essential. While prior studies have quantified wellbeing/burnout, few have defined wellbeing from the resident–physician perspective. A REDCap® survey was distributed to residents in various programs, responses were grouped by theme, and data analyzed via chi-square. From 19 institutions, 53/670 responded, from university (34.0%), community (30.2%), and community/university-affiliated (30.2%) programs, mostly surgical (84.9%), followed by medical (9.4%). Wellbeing was defined by mental and spiritual/religious health (33.8%), overall health (23.0%), free time/time management (23.0%), and job/salary satisfaction (18.9%). Proposed changes to traditional training included fewer hours and more schedule flexibility (38.2%), and increased/improved support/feedback (14.7%). Nearly half of the respondents perceived lacking education on career longevity. Wellbeing is paramount to the personal/professional development of residents. Data on resident-defined wellbeing are lacking. The improved understanding of wellbeing defined here can be used to improve residency training programs.

Estudio descriptivo sobre libranza de guardias de Médicos Residentes de Madrid: Efecto de la huelga de 2020 en el cumplimiento de los descansos obligatorios

Antecedentes: Este estudio tiene como objetivo describir el grado de cumplimiento de los descansos obligatorios tras las jornadas de trabajo de 24 horas (guardias) en el colectivo de médicos residentes en la Comunidad de Madrid y el efecto que la huelga de residentes de 2020 ha tenido en el cumplimiento de dichos descansos. Métodos: Se ha diseñado un estudio descriptivo observacional transversal a través de una encuesta online anónima adaptada de la bibliografía existente. Resultados: Antes de la huelga de residentes el 27,2% de los encuestados no realizaban los descansos obligatorios después de las guardias. El descanso semanal obligatorio de al menos 36 horas no se respetaba hasta en el 87% de los casos. Después de la huelga de residentes, estos porcentajes se han reducido a un 19,8% y un 34,5% respectivamente, con significación estadística comparándose con los porcentajes previos (p<0,05). La media de guardias realizadas en la muestra era de 5 al mes, lo que supera el máximo legal de horas semanales. Conclusiones: Se constata la vulneración de los derechos laborales de los residentes en un importante porcentaje de los residentes en lo relativo a los descansos obligatorios post-guardia y descansos semanales. La huelga de residentes ha reducido la incidencia del fenómeno, pero sigue siendo un problema relevante para la salud de los residentes y la seguridad del paciente. Background: This study aims at describing the absence of mandatory rest periods after a 24h on call shift in resident physicians in the region of Madrid. It also tries to elucidate the effect which the 2020 resident physician’s strike has had in this phenomenon. Materials and methods: A descriptive observational cross-sectional study has been carried out through an anonymous survey adapted from the available literature. Results: Before the resident’s strike up to 27,2% of the residents surveyed could not enjoy mandatory resting periods after a 24 hour on-call shift. The mandatory weekly rest of at least 36 hours was not done in up to 87% of the cases. After the residents' strike, these figures have been reduced to 19.8% and 34.5% respectively, with statistical significance comparing with previous percentages (p <0.05). The average number of 24 hours on call shifts residents had to work per month was 5, which exceeds the maximum weekly hours allowed by law. Conclusions: The findings reveal a violation of resident physician labor rights in relation to the mandatory days-off after 24-hour on call shifts and weekly breaks. The resident physician’s strike has reduced the incidence of the phenomenon, but it remains a relevant threat to resident physician’s health and patient safety.

Improving physician wellness through electronic health record education

Objective Our goal is to improve the wellness of our Family Medicine residents now and in the future by educating them on more efficient use of our electronic health record (EHR). Resident physician burnout is a significant problem and is correlated with time spent using an EHR after work hours. Family physicians have the highest rate of burnout of all specialties, and the EHR is a significant contributor to this burnout. Studies have shown that increased EHR education can improve job satisfaction. Method Over 5 months, we provided weekly brief (15 minute) educational sessions covering 6 topics twice and a one-hour individualized meeting of each resident physician with an EHR trainer. We evaluated our intervention with wellness surveys and objective measures of EHR efficiency both pre and post intervention. We further evaluated efficiency by comparing pre and post-intervention values of the following: average keystrokes, mouseclicks, accelerator use, minutes per encounter and percent closed encounters at month’s end. Results Resident questionnaires showed lessons increased knowledge and intention to use EHR accelerators, but this was not statistically significant. Analysis of objective data showed most efficiency metrics worsened, though most not to a degree that was statistically significant. Residents reported subjective increases in efficiency, and paired data from wellness surveys showed an overall decrease in burnout post-intervention vs. baseline. Conclusions Much of the data in this pilot study does not reach statistical significance, but is highly suggestive that increased EHR training can improve at least perceived efficiency and thereby resident wellness.