Burnout syndrome among internship medicalstudentsAna T R de Abreu Santos, Suely Grosseman, Edme´aF de Oliva Costa & Tarci´sio M de AndradeContext and setting During our experience of15 years teaching a paediatrics internship in a publicfederal university in Brazil, we have recognised insome of our medical students the presence of psycho-emotional conflicts concerning the educationalmodel and interpersonal relationships within medicalschool. These conflicts seem to influence the healthof future professionals, the quality of theirrelationships and the care they deliver to patients.Although ours is the first medical school to have beenestablished in Brazil, it does not have in place asystematic service to promote and care for the mentalhealth of undergraduates. The provision of such aservice is especially important in view of thecurriculum reform taking place in line with theNational Curriculum for Medical EducationGuidelines defined by the Ministry of Education andthe subsequent inclusion of a more humanisticapproach.Why the idea was necessary Systematic research wasundertaken to enable us to better understand themental health needs of students. During the study, wehad the opportunity to work more closely with ourschool’s board of directors. This has strengthened thepossibility of developing a project to establish aprogramme of institutional support for the mentalhealth of medical students, focusing onthe promotion and support of mental health,the prevention of possible illness occurrence in thecourse of a future career, and eventually resulting inthe provision of more effective care to the population.What was done With the approval of our institution’sethics committee, a survey was conducted duringJanuary–December 2010 to assess the incidence ofsymptoms of burnout syndrome (BS) and associatedfactors among interns at medical school (n = 303).We used qualitative and quantitative methods. Twofocus groups were conducted with 18 students andtwo questionnaires (a specific questionnaire [SQ] andthe Maslach Burnout Inventory-Student Survey[MBI-SS]) were administered to and returned by234 subjects (77.2%). Results were subsequentlyanalysed.Evaluation of results and impact The MBI-SS showedhigh scores on emotional exhaustion (63.2%) andcynicism (53.8%), as well as low professionaleffectiveness (50.9%). The prevalence of BS was14.5%. Characteristics of students likely to sufferBS included: being a fifth-year intern; being single;being male; being childless; living with parents; nothaving one’s own income; desiring to leave college;having a good academic record; considering oneselfas insufficiently skilled to be a doctor, and nothaving developed mental illness before or duringmedical training. These results are in agreement withthe contents of the focus groups, in which issues thatarose included: the participants’ medical training(e.g. the high requirements of the course, thedifficult path to academic qualification, insecurityabout having skills sufficient to practise medicine,interpersonal relationship difficulties, the need topostpone personal life projects); psycho-emotionalsuffering related to the physical and mental health ofinterns (e.g. physical illness, changes in behaviour),and feelings of extenuation, anguish, injustice, stressand frustration. These findings may contribute tothe development of BS in this population. Based onthe initial report of these findings to the board ofdirectors, a decision was made to build an effectivepartnership with the medical school to put in placean institutional support unit for medical students.In the future, further studies will be carried out tosupport the comparison of findings on equivalentparameters after the implementation of the unit.
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