Burnout: exploring the differences between U.S. and international medical graduates

Onge, Joan E. St.; Allespach, Heidi; Diaz, Yvonne; Poitier, Alexandria; Tamariz, Leonardo; Paidas, Charles N.; Palacio, Ana

doi:10.1186/s12909-022-03135-x

Cited by 9 publications

(8 citation statements)

References 44 publications

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“…Physicians working longer hours, or those working in primary care had higher odds of emotional exhaustion and feeling depersonalization. IMG status and greater work experience decreased both emotional exhaustion and depersonalization, which is consistent with previous research [ 16 , 17 ].…”

Section: Resultssupporting

confidence: 92%

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Do physicians with academic affiliation have lower burnout and higher career-related satisfaction?

Zhuang

Dill

2022

BMC Med Educ

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Background Physicians report increasing burnout and declining career-related satisfaction, negatively impacting physician well-being and patient care quality. For physicians with academic affiliations, these issues can directly affect future generations of physicians. Previous research on burnout and satisfaction has focused on factors like work hours, gender, race, specialty, and work setting. We seek to contribute to the literature by examining these associations while controlling for demographic, family, and work-related characteristics. Furthermore, we aim to determine any differential effects of faculty rank. Methods We analyzed data on practicing physicians in the U.S. from the Association of American Medical College’s (AAMC) 2019 National Sample Survey of Physicians (NSSP,) which includes variables adapted from the Maslach Burnout Inventory. We used ordinal logistic regressions to explore associations between academic affiliation and burnout. We conducted a factor analysis to consolidate satisfaction measures, then examined their relationship with academic affiliation using multivariate linear regressions. All regression analyses controlled for physicians’ individual, family, and work characteristics. Results Among respondents (n = 6,000), 40% were affiliated with academic institutions. Physicians with academic affiliations had lower odds than their non-affiliated peers for feeling emotional exhaustion every day (Odds Ratio [OR] 0.87; 95% CI: 0.79–0.96; P < .001) and reported greater career-related satisfaction (0.10–0.14, SE, 0.03, 0.02; P < .001). The odds of feeling burnt out every day were higher for associate professors, (OR 1.57; 95% CI: 1.22–2.04; P < .001) assistant professors, (OR 1.64; 95% CI: 1.28–2.11; P < .001), and instructors (OR 1.72; 95% CI, 1.29–2.29; P < .001), relative to full professors. Conclusions Our findings contribute to the literature on burnout and career satisfaction by exploring their association with academic affiliation and examining how they vary among different faculty ranks. An academic affiliation may be an essential factor in keeping physicians’ burnout levels lower and career satisfaction higher. It also suggests that policies addressing physician well-being are not “one size fits all” and should consider factors such as academic affiliation, faculty rank and career stage, gender identity, the diversity of available professional opportunities, and institutional and social supports. For instance, department chairs and administrators in medical institutions could protect physicians’ time for academic activities like teaching to help keep burnout lower and career satisfaction higher.

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Section: Resultssupporting

confidence: 92%

“…We saw an increase in career satisfaction and time use satisfaction with every additional year in practice. IMG status was associated with higher satisfaction on both measures, which is consistent with previous research [ 17 ].…”

Section: Resultssupporting

confidence: 92%

Do physicians with academic affiliation have lower burnout and higher career-related satisfaction?

Zhuang

Dill

2022

BMC Med Educ

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“…Studies on burnout in medical students have revealed an increased risk in females (Dyrbye, Thomas, Huschka, et al, 2006) and older age groups (Dyrbye, Satele, & West, 2021); however, inconsistencies across studies have been found (Dyrbye, Thomas, Huntington, et al, 2006). Furthermore, differences between countries regarding burnout in medical students have been reported in the existing literature, with higher prevalence in Oceania (Frajerman et al, 2019) and US (St Onge et al, 2022) as compared to other parts of the world. These differences have been related to several country-specific factors, including a wide variation in lifestyle patterns (Lee et al, 2020), family support (Dorrance Hall et al, 2017), and learning environments of medical schools (Bilge et al, 2014; Brown et al, 2007).…”

Section: Introductionmentioning

confidence: 99%

Prevalence of burnout in medical students: A systematic review and meta-analysis

Almutairi

Alsubaiei

Abduljawad

et al. 2022

Int J Soc Psychiatry

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Background: Medical students are at a significant risk of experiencing psychological issues, such as burnout. Over the past few years, more studies have been conducted on this topic, producing different results. Aims: The purpose of this review was to determine the global pooled prevalence rate and risk factors associated with burnout and its components among undergraduate (pre-intern) medical students. Method: From inception until 30 November 2021, nine electronic databases were used for an electronic search. Using random-effects meta-analysis, we pooled the estimates using the DerSimonian-Laird method. The prevalence of burnout in medical students was the primary outcome of interest. Data were analyzed globally, by country, by research measure. Age and sex were examined as confounders using meta-regression analysis. Results: A random-effects meta-analysis of 42 studies involving 26,824 evaluating the prevalence of burnout in medical students showed an overall prevalence rate 37.23% [32.66%; 42.05%], Q = 2,267.15(41), p < .0001, τ2 = .42, τ = .65, I2 = 98.2%; H = 7.5. Prevalence of emotional exhaustion, depersonalization, and personal accomplishment were 38.08% [30.67%; 46.10%], 35.07% [26.74%; 44.41%], and 37.23% [32.66%; 42.05%], respectively. Variations were observed between countries and research measures. Age (older) and sex (female) were both significant predictors of burnout. Conclusion: The prevalence of burnout in medical students was estimated to be 37.23%. It is urgent that future studies serve as a basis for the development of prevention and treatment programs to prevent and treat burnout in students.

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“… 13 , 14 , 15 , 16 The CBI has been applied extensively to physicians. 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 Despite widespread international use in measuring burnout among physicians, the CBI has been used infrequently to measure burnout among emergency physicians in the United States. 37 , 38 …”

Section: Introductionmentioning

confidence: 99%

“…The CBI has been used to assess varied types of health care personnel in several countries, amassing substantial validity evidence 13–16 . The CBI has been applied extensively to physicians 17–36 . Despite widespread international use in measuring burnout among physicians, the CBI has been used infrequently to measure burnout among emergency physicians in the United States 37–38 …”

Section: Introductionmentioning

confidence: 99%

Reliability and validity support for an abbreviated Copenhagen burnout inventory using exploratory and confirmatory factor analysis

et al. 2022

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Objective The Copenhagen Burnout Inventory (CBI) is an open‐access, valid, and reliable instrument measuring burnout that includes 19 items distributed across the following 3 domains (factors): personal burnout, work burnout, and patient burnout. The primary objective of this study was to determine the validity and reliability of an abbreviated CBI to assess burnout in emergency medicine residents. Methods This cross‐sectional study used data from the CBI that followed the 2021 American Board of Emergency Medicine In‐training Examination. Exploratory factor analysis (EFA) was followed by confirmatory factor analysis (CFA). Results Of the 8491 eligible residents, 7225 (85.1%) completed the survey; the EFA cohort included 3613 residents and the CFA cohort included 3612 residents. EFA showed 2 eigenvalues ≥1, an internal factor and an external factor. There were 6 CBI items that contributed to the 2 factors. The first factor was related to personal burnout and work‐related burnout and the second factor was related to working with patients. There were 4 CBI items that contributed to the internal factor and 2 CBI items that contributed to the external factor. Using the abbreviated CBI, the incidence of a resident having 1 or both types of burnout was 34.1%. Conclusions This study provides validity evidence and reliability support for the use of a 6‐item, 2‐factor abbreviated CBI. A shorter, reliable, valid, and publicly accessible burnout inventory provides numerous advantages for burnout research in emergency medicine.

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Burnout: exploring the differences between U.S. and international medical graduates

Cited by 9 publications

References 44 publications

Do physicians with academic affiliation have lower burnout and higher career-related satisfaction?

Do physicians with academic affiliation have lower burnout and higher career-related satisfaction?

Prevalence of burnout in medical students: A systematic review and meta-analysis

Reliability and validity support for an abbreviated Copenhagen burnout inventory using exploratory and confirmatory factor analysis

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