Abstract
It is widely recognized that burnout is prevalent in medical culture and begins early in training. Studies show pediatricians and pediatric trainees experience burnout rates comparable to other specialties. Newly developed Accreditation Council for Graduate Medical Education (ACGME) core competencies in professionalism and personal development recognize the unacceptably high resident burnout rates and present an important opportunity for programs to improve residents experience throughout training. These competencies encourage healthy lifestyle practices and cultivation of self-awareness, self-regulation, empathy, mindfulness, and compassion—a paradigm shift from traditional medical training underpinned by a culture of unrealistic endurance and self-sacrifice. To date, few successful and sustainable programs in resident burnout prevention and wellness promotion have been described. The University of Arizona Center for Integrative Medicine Pediatric Integrative Medicine in Residency (PIMR) curriculum, developed in 2011, was designed in part to help pediatric programs meet new resident wellbeing requirements. The purpose of this paper is to detail levels of lifestyle behaviors, burnout, and wellbeing for the PIMR program’s first-year residents (N = 203), and to examine the impact of lifestyle behaviors on burnout and wellbeing. The potential of the PIMR to provide interventions addressing gaps in lifestyle behaviors with recognized association to burnout is discussed.
Highlights
Medical school and residency training are known for their scientific rigor and daunting hours of service [1,2]
The sample consisted of 203 first-year residents from four incoming classes (2012, n = 15; 2013, n = 88; 2014, n = 59; 2015, n = 41) at five pediatric residency programs participating in the Pediatric Integrative Medicine in Residency (PIMR)
Accruing research suggests that first-year residents enter training with high levels of burnout, emphasizing the need for effective solutions to address burnout in medical education
Summary
Medical school and residency training are known for their scientific rigor and daunting hours of service [1,2]. Children 2018, 5, 54 by exposure to significant human suffering, high levels of responsibility, lack of day-to-day control, steep learning curves, limited regeneration time, and chronic sleep deprivation. These realities, in conjunction with patient and family demands, subordinate ranking in the medical hierarchy, and other stressors predispose residents to high burnout prevalence [1,2]. Across medical specialties and training levels, burnout has been associated with an increase in medical errors, lower adherence to best practices, substance abuse, self-medication, and poorer patient outcomes (for example, longer hospital stay), in addition to increased rates of clinician’s depression, suicidal ideation, and completed suicide [7].
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