Subjectively Experienced Workload during Continuing Education in General Medicine and Demands on a Competence Center: A Cross-Sectional Study from Saxony-Anhalt

Abstract

The expectations of trainees in training at Centers of Excellence are still partly unclear. Recent studies demonstrated the negative impact of high workload and stress on young doctors' mental health, a problem since the start of their careers. From trainees' point of view, are there differences in subjective occupational stress between inpatient and outpatient care sectors? How does a high subjective workload of general medicine trainees affect the demands made on the Centers of Excellence? Design: cross-sectional study from March to June 2017 in Saxony-Anhalt Sample: every general medicine trainee registered with the KOSTA (n=221) Questionnaire: self-developed; content: demands on a Center of Excellence, sociodemographic parameters, biography of qualification, evaluation of previous postgraduate training in inpatient and outpatient care sectors, questionnaire about effort-reward-imbalance (ERI). In total, 73 responses from the trainees were received (33.0%). Every single response was included in the analysis. Occupational stress was specified on an averaging index from 1 (lowest) to 4 (highest). Higher workload was reported in the inpatient care sector (inpatient: 2.8 vs. outpatient: 2.1, p<0.01). The subjective workload was significantly increased by the amount of overtime work (inpatient: η²=18.3%, p=0.02, outpatient: η²=28.3%, p<0.01). Persons with above-average occupational stress tended to express a higher need for complete planning of qualification (percentage difference d%=0.31), mentoring (d%=0.15) and informal exchange with colleagues (d%=0.19). Trainees' feeling of occupational stress was proved to be independent of personal and demographic characteristics. General practice trainees need more mentoring with higher levels of occupational stress. This has to be considered when individual consulting is offered.