Acknowledging the issue of burnout among Residents and helping them bounce back
By Adj Assoc Prof Audrey Chia
Programme Director, Ophthalmology, SingHealth Residency
Senior Consultant, Paediatric Ophthalmology and Adult Strabismus Service, Singapore National Eye Centre
Everyone feels overwhelmed by the avalanche of work and family responsibilities at times. That is perfectly normal. However, if negative feelings persist and you find yourself constantly feeling depressed, it could be more than just a case of the usual Monday blues.
Do you find yourself losing your sense of purpose in your work? Do you behave in a negative way towards your patients or become irritated easily? Chances are, you may be suffering from burnout.
Burnout can have negative effects on your mental state, relationships with colleagues and family, and if you’re a healthcare professional, your ability to care for patients.
In 2015, my team at Ophthalmology Residency Programme conducted a survey among Residents and Faculty members. We discovered that up to 20 per cent of our Residents and Faculty may be suffering from burnout,as defined by the Malasch Burnout Scale(1). The sample of respondents was limited to our specialty, but I suspect that a similar trend may be reflected in other programmes.
Residency is a very stressful time, especially for young doctors who have just embarked on their medical careers. There are expectations for them to pass examinations, be on calls, be clinically competent and responsible for patients as well as take part in research. While some will rise to the challenge, others may struggle.
Many Residents are high achievers with stellar academic records. As such, when they encounter setbacks during their Residency programme, some find it stressful and struggle to cope with a perceived sense of inadequacy.
"We discovered that up to 20 per cent of our Residents and Faculty may be suffering from burnout ... I suspect that a similar trend may be reflected in other programmes."
How then do we help our Residents cope? The first step is to for us to acknowledge that burnout exists and to recognise the symptoms, so that they can be given timely support. In some cases, all that is needed is a sympathetic ear.
When counselling Residents, we teach them to be more self-aware of the emotions that they are feeling, help them accept their strengths and weaknesses, and encourage them to seek help when required.
In assessing stressors, however, we need to be aware that these may not be just work-based. Many trainees have busy personal lives – some have young children or ageing parents to care for, on top of their different roles at work. Juggling the different responsibilities without adequate support can be stressful.
Often, I find that some Residents place too much pressure on themselves by trying to get as many cases and projects done as quickly as possible. I always tell them to not be in such a rush! During the five years in the Residency programme, they should set personal priorities, tackle one exam at a time and pace themselves.
Of course it is inevitable that there will be times when things get more stressful, but at other times, I encourage my Residents to stop and appreciate the positive things in life. Treasuring friendships at work, time spent with patients, and the knowledge that we can make a difference in someone’s life, these are priceless reminders of why we work in healthcare.
It can be difficult to detect when a colleague is displaying symptoms of burnout, especially when everyone is working under pressure. It is even harder to realise and acknowledge when we ourselves are suffering from burnout.
This is why I hope that by acknowledging the problem and recognising the symptoms, we can be more understanding and lend a helping hand to our trainees, when needed. After all, when we take care of our staff, we can then take better care of our patients.
WHAT IS BURNOUT?
Burnout is a psychological syndrome that occurs among professionals who work with other people in challenging situations, involving(2):
• Emotional exhaustion – feeling that one can no longer give of themselves at a psychological level
• Depersonalisation – negative, cynical attitudes toward clients
• Diminished sense of personal accomplishment – feeling unhappy about one’s self and dissatisfied with accomplishments on the job
Reference:
1. Maslach C, Jackson SE. Maslach Burnout Inventory. Palo Alto: Consulting Psychologists Press; 1981a.
2. Maslach C. Burnout: The cost of caring. Englewood Cliffs, NJ: Prentice Hall; 1982.
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