Assessment of Burnout among Medical Post Graduate Students of 2020 BatchPosted in Victoria Hospital for Non COVID Duties: A Cross Sectional Study

Introduction

Burnout syndrome is a psychological syndrome arising from a continued response to chronic interpersonal stressors while at work. The term was first coined in 1974.1 It is defined as a state of physical and mental exhaustion related to caregiving activities or work.¹ Work related stress is a serious issue among the healthcare workers, especially for resident doctors who are posted on duties with insane duty hours without breaks for various day to day needs. The syndrome among both doctors in practice and in training has reached epidemic levels, with a prevalence near to or exceeding 50%.² The consequences of burnout are potentially severe for caregivers, patients and health institutions, and includes the risk of medical errors, depression, and adverse effects on patient safety.³

Materials and Methods

An online survey to assess burnout was conducted among residents across Victoria Hospital during the months of July to November 2021. The survey was conducted after Institutional Ethics Committee clearance and was totally anonymous. There were multiple sections in the survey, which included the demographic details, stress-related variables, and the Copenhagen Burnout Inventory. Data were collected in Google forms and then transferred to Excel sheet and analyzed.

Tools

A questionnaire with three sub-dimensions: Personal burnout, work-related burnout, and client-related burnout. The three separate parts of the questionnaire were designed to be applied in different domains. The questions on personal burnout were formulated in a way so that all human beings can answer them (a truly generic scale). The work-related burnout questions assume that the respondent has paid work of some kind. Finally, the client-related burnout questions include the term ‘‘client’’ (or a similar term when appropriate such as patient, student, inmate, etc.).

Personal burnout: Personal burnout is the degree of physical and psychological fatigue and exhaustion experienced by the person.

Work-related burnout: The degree of physical and psychological fatigue and exhaustion that is perceived by the person as related to his/her work.

Client-related burnout: The degree of physical and psychological fatigue and exhaustion that is perceived by the person as related to his/her work with clients.⁴

Results

Among the 240 post graduate students, 187 consented for participation which was comprised of 65 (35.8%) females and 120 (64.2%) males. Majority 173 (92.5%) participants belonged to the age group of 24 to 29 years, with mean age of 26.1 years and SD of 1.8 years. Out of 187 participants, 163 were residing in hostel and 24 were residing at rented or parents owned/rented homes. Among 187, 163 (87.1%) were involved in night duties in the past two weeks before they were enrolled for participation in the study and 154 (82.3%) were on duty for more than 12 hours including night time, with mean hours of continuous duty of 16 hours with SD of 2.3 hours.

The scores for three domains of Copenhagen Burnout Inventory by the participants are as per the following table.

Discussion

We used the Copenhagen Burnout Inventory which assessed burnout among the participants in last two weeks from the date of participation in the study. Limited number of factors were considered that were contributing to the burnout in order to receive better compliance from the participants.

Our findings are in line with the study conducted by Shanafelt TD et al which stated that the professional characteristics associated with a higher overall risk of burnout including area of specialization (higher risk among trauma surgeons, urologist, otolaryngologists, vascular surgeons, and general surgeons), a higher number of nights on call per week, working more hours per week, contributes to higher levels of burnout.²

In a literature review conducted by Ishak et al., findings from one of the study stated that burnout rates were 75% in obstetrics-gynecology, followed by 63% in internal medicine, 63% in neurology, 60% in ophthalmology, 50% in dermatology, 40% in general surgery, 40% in psychiatry, and 27% in family medicine. The findings are similar to our study in terms of quantity of the burnout but it varied with respect to the specialty wise grading of the burnout.³

The present study has its limitations as it was a cross sectional study conducted to assess the situation in last two weeks from the date of participation. Moreover, as burnout is a chronic phenomenon, it might still get affected by the rare or non-regular events happening in the lives of residents. Better research in terms of factors affecting burnout and study design is required to gain complete knowledge about the depth of the problem.

Conclusion

The burnout is highest among the doctors working in the specialties which are always available round the clock such as general medicine, general surgery and obstetrics and gynecology, whereas it is in mild to moderate levels among the specialties with less patient load and minimal in newer specialties like immunohematology. In most of the doctors, the major contributor of the burnout is the patient related component in comparison with those facing mild to moderate form of burnout where the major contributor is the work-related burnout. In addition to the same, there was minimal contribution of the personal related burnout in almost all specialties.

The correlation to the burnout score and various factors was assessed using Pearson’s correlation coefficient and it was found that the rude behavior of the patients or their attenders had the highest positive correlation followed by more than 12 hours of night duties. Stay at hostel showed negative correlation with respect to burnout. There was weak positive correlation among burnout scores with respect to replacement duties.

Conflict of Interest

None.