Job satisfaction of medical interns: a qualitative study using Herzberg’s hygiene motivation theory

Abstract

Background: Human resource management policies and practices are not well understood and implemented in some health care settings. Besides affecting client outcomes, poor management practices can adversely affect the health and wellbeing of healthcare professionals such as nurses and doctors. The junior most doctors in the medical hierarchy of a hospital are interns. Owing to long working hours and heavy workloads, internship can be quite a stressful experience resulting in unprofessional and unethical behaviours as well as increased number of medical errors. Although there is an abundance of research on the difficulties faced by interns, there is a paucity of research highlighting their job satisfaction. Identifying factors that influence interns’ job satisfaction could inform better working conditions for interns as well as improve client outcomes and overall hospital performance. Methods: Job satisfaction was explored by one-to-one semi-structured interviews with 12 senior interns within the theoretical framework of Herzberg’s ‘hygiene-motivation’ or ‘two factor theory’. Data were analysed thematically. Results: Reasons for job satisfaction included feeling supported in the work place as well as getting quality supervision, teaching and clinical exposure. Reasons for job dissatisfaction included poor access to administration, unduly stressful working situations, lack of support for mental health and wellbeing and poorly organised teaching sessions. The results of this study closely align with Herzberg’s motivation hygiene theory showing that reasons for job satisfaction are mostly different from reasons for job dissatisfaction. Conclusion: The internship experience, together with the people they are influenced by, can determine a doctor’s future career pathway. It is therefore vital for internship coordinators and hospital managers to facilitate a positive internship experience. The findings have implications for human resource management policy and practice in hospitals.