AMMAN — A new study has found that over three-quarters (77.5 percent) of medical residents in Jordan experience burnout. The symptoms of burnout have an impact on both the residents themselves and their patients, according to experts speaking with
Jordan News.
اضافة اعلان
Burnout was first defined in the 1970s, defined as “a syndrome of physical, mental, and emotional exhaustion that arises in response to continuous stress,” according to the article. The study was published in the International
Journal of Environmental Research and Public Health, a peer-reviewed and open access academic journal.
“It is defined as a state of physical exhaustion, underappreciation, and a feeling of underachievement,” said Abdullah Nimer, the first author of the study and a senior medical student at the
University of Jordan, in an interview with
Jordan News. “The resident will feel physically incapable of doing his or her job.” He explained that while the phenomenon has been documented in many professions, it is particularly prevalent within healthcare. He attributed burnout to “continuous job stress.”
Nimer said that the inspiration for the study came from his and his coauthor, Suzan Naser’s, observations of resident doctors around them. In Jordan, doctors first undergo six years of medical school, then a one-year internship before they are eligible for residency, where they practice medicine under direct supervision and training in a specialty. The residency can take from four to six years.
The residents he met as a medical student “did not look healthy,” the author said. “They did not feel appreciated in their jobs, even though most people who think about being a doctor will think it’s a high income job; a prestigious job.” He described his desire to “shed light on the evidence” of this anecdotal observation through his research. The rates of resident burnout the research identified in Jordan are higher than those in Saudi Arabia, the United States, Yemen, Qatar, and Canada, among other countries — though Nimer noted that not all those countries used the same metric for measuring burnout.
Residents “are actually on the frontlines with the patients, because they are seeing patients in the emergency department, in the clinics, in the wards,” said Ismail Matalka, professor of pathology at King Abdullah University Hospital and Jordan University of Science and Technology, in an interview with
Jordan News.
The doctor explained that burnout has “impacts on patients and the healthcare system.”
Burnout occurs when “the resident feels he cannot cope with his work” and feels “very stressed and even sometimes feels so depressed, disappointed,” said Matalka. He explained that burnout results in physical and emotional fatigue, which can contribute to medical errors. “This is against the safety measures of practice.”
“An increase in working hours directly relates to an increase in burnout level, which makes a lot of sense,” said Nimer. He explained that residents in Jordan can work up to 100 hours a week — whereas in the United States, for instance, regulations have been implemented that limit them to working 80 hours a week.
“This happens because hospitals do not hire enough doctors,” explained Nimer. “They don’t want to pay for enough doctors.
They want to do two shifts a day, 12 hours each, instead of three shifts.” However, he pointed out that “In the long term, we don’t know if this is actually cost-effective” because of the increased rate of medical errors caused when doctors work exhausting hours. The study found that certain specialties, such as obstetrics and gynecology, had significantly higher rates of burnout than others, which the authors attributed to longer working hours within those specialties.
High hours are also linked to the two-pronged residency program, which provides both paid and unpaid paths for residency. “Both have the same schedule and the same workload,” said Nimer. “One of them takes a paid salary. The other one just, not only don’t they get paid, they have to pay the institution about JD3,000,” he explained, a discrepancy that he described as “ridiculous”.
Residents in unpaid programs “usually work another job at a clinic, private clinic, or a private practice, to make some money.” This unpaid option is kept alive by the fact that new doctors outnumber the number of spots in residency programs available, according to Nimer.
Matalka emphasized that accrediting bodies need to provide guidelines to prevent burnout and promote a healthy work-life balance for physicians. “It’s at the top of the priorities in accrediting the training programs,” he said. He highlighted the importance of guaranteeing that the “educational environment is actually preventing such burnout and promoting wellbeing.”
He also recommended that there be “a platform where the residents actually can give some kind of continuous feedback about their working environment, training environment.”
Nimer recommended that residency training programs offer more sick leave and vacation days, as well as enabling doctors who take night shifts to only take night shifts, rather than being required to work a night shift and day shift consecutively. He suggested residency programs with high rates of burnout, like obstetrics and
gynecology, hire more residents. “These all are suggestions that are not tested yet,” he pointed out, calling for more research on the efficacy of these interventions.
“I don’t think residents are aware of their rights,” Nimer added. “I don’t think they’re aware of their mental or psychological health.”
“If they’re not taking care of their health, how can I trust them with my health?” the author concluded. “I would be worried if I went to a hospital knowing that the doctor treating me is not getting paid.”
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