Offsetting Burnout Among Medical Cadets During Internship Year: The Role of Empowerment, Continuous Appraisal, Psychological and Career Counseling. An 18-Months Successful Experience in a Tertiary Medical Center.

Abstract

Background. Following graduation from school of medicine, Israeli medical cadets complete a 12-months training period in hospitals. This year, their jump-start of career, has profound influence on their future contribution to our national workforce. The crisis in the healthcare system begins in this group of physicians, with burnout, sense of personal and professional uncertainty and disorientation resulting from the nature of their changing environment. Methods. In the largest Israeli tertiary hospital, we established an education authority, overseeing cadets as trainees rather workers. We offer them constructed, personalized psychological and counselling services with continuous process of appraisal. All is taking place in a designated unit within our education authority. During an 18-month period we followed their monthly feedbacks relating to their satisfaction, learning experience and level of socialization with their peers and superiors. Results. Statistically significant improvement of monitored parameters was evident, with interns stationed in the surgical departments (n = 86) showing the highest degree of improvement: the extent of acquiring new knowledge and competencies [Likert questionnaire results (1 to 5 LQR) went from 2.2 ± 1.0 to 3.3 ± 1.42 ; p < 0.005]; experience from the absorption process into the department [LQR from 2.6 ± 1.2 to 3.5 ± 1.56 ; p = 0.04], degree of motivation to recommend peers to apply for residency [LQR from 2.3 ± 1.0 to 3.1 ± 1.6 ; p = 0.05] and the experience of being accepted to the department by the staff nurses [LQR from 2.7 ± 1.3 to 3.5 ± 1.1 ; p = 0.03]. Conclusions. An ongoing process of appraisal, empowerment, psychological and career counseling seems promising in the relenting effort to withhold the burnout process of young physicians. We suggest that a policy of constructing in-hospital education authorities will give rise to similar efforts that will take place in more hospitals and for other physicians' populations, e.g. residents and senior physicians.