Abstract
Physician burnout has been recognized as a public health crisis. However, there is a paucity of burnout studies in the context of medical internship. We assessed the prevalence and relationship between various training characteristics, personal variables, resilience, and coping with burnout in a cross-sectional study involving 837 interns from ten hospitals across Malaysian healthcare system. The instrument package included demographic questions, the Connor–Davidson Resilience Scale, Brief COPE and the Copenhagen Burnout Inventory. A total of 754 (90.1%) interns completed the inventories. We found a high prevalence of personal-related (73.3%), work-related (69.1%), and patient-related (43.4%) burnout among Malaysian interns. Multivariable analysis showed female gender (odds ratio (OR):1.50; 95% confidence interval (CI): 1.02–2.20), prior work experience (OR: 1.56; 95% CI: 1.05–2.30), and irregular spirituality routines (OR: 1.97; 95% CI: 1.30–2.99) were associated with increased odds of personal-related burnout. Irregular spirituality routines (OR: 2.24; 95% CI: 1.49–3.37) were associated with work-related burnout, while living with other people (OR: 1.77; 95% CI: 1.15–2.73) was associated with patient-related burnout. Lower resilience levels and avoidant copings were associated with personal-, work-, and patient-related burnout. Burnout prevalence among interns is high. The findings support the value of individual-targeted alongside organizational-targeted intervention in burnout reduction. As burnout is prevalent in both years of internship training, ongoing burnout prevention and wellbeing measures are deemed necessary.
Highlights
Burnout can be defined as work-related, multi-dimensional psychological syndrome that can be characterized by exhaustion, depersonalization and a reduced sense of personal accomplishment [1,2]
We found that self-blame (OR, 2.63; 95% confidence interval (CI): 1.66–4.19), self-distraction (OR, 1.99; 95% CI: 1.37–2.89), irregular spirituality routines (OR, 1.97; 95% CI: 1.30–2.99), prior work experience (OR, 1.56; 95% CI: 1.05–2.30), being female (OR, 1.50; 95% CI: 1.02–2.20), or having a lower resilience score (OR, 0.89; 95% CI: 0.86–0.92) were independently associated with personal-related burnout
Previous work in Malaysia proposed that burnout was highest in the first six months of internship [10], our findings suggested that burnout was high in both years of training
Summary
Burnout can be defined as work-related, multi-dimensional psychological syndrome that can be characterized by exhaustion, depersonalization and a reduced sense of personal accomplishment [1,2]. Recent systematic review reported an alarming burnout prevalence among physicians (up to 80.5%) [3]. Burnout was shown to be more prevalent in physicians at various stages of medical training than in their peers from the general population [4,5]. Burnout can be driven by various long-term stressors such as heavy workload, long hours, required use of electronic medical records, lack of job autonomy and poor interpersonal relationship [6,7]. In a person who experienced burnout, the enthusiasm turned to exhaustion, the fulfilling involvement became cynicism and the efficiency declined to inefficacy [1]. Very few studies have examined the long-term impacts of burnout, a growing body of evidence have linked burnout with patient care practices (increased medical errors, longer recovery time, reduced patient satisfaction, and reduced perceived safety), organizational performance indicators (reduced productivity, increased turnover and costs) and physician health (increased substance abuse, depression and accidents) [7,8]
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