Interesting article I just came across........... Study reveals stresses of UW med residents 3 out of 4 say they suffer from burnout; half say they sometimes gave insufficient care Tuesday, March 5, 2002 SEATTLE POST-INTELLIGENCER STAFF AND NEWS SERVICES Three out of four medical residents in a University of Washington study report suffering from "burnout," and half of those said they sometimes gave less-than-ideal care. Too little sleep, frequent shifts longer than 24 hours and lack of leisure time were most often rated as major stresses by residents in the university's internal medicine residency program. The study, published yesterday in the Annals of Internal Medicine, is the largest study so far of burnout in medical residents, a syndrome characterized by emotional exhaustion, a sense of overwhelming workload and an unhealthy detachment from patients. Although medical training has always been rigorous, the pressures faced by today's residents are different and may contribute to a higher rate of burnout, said Dr. Joyce Wipf, director of the residency program at UW, and one of the study's authors. "Patients are coming in sicker and going home more quickly," she said. Treatment choices are also more complex, and young doctors have less time to develop relationships with their patients. In addition, the social support for residents has changed. "Their personal pressures are greater," she said. "It's harder for residents to put their personal lives on hold. Their significant others have their own careers to deal with." Dr. Anthony Back, a UW medical professor and one of the authors of the study, said the research didn't determine whether patient care was affected. But according to the study, slightly more than half the residents experiencing burnout reported one or more "suboptimal" patient-care practices at least monthly, compared with about 21 percent of residents not experiencing burnout. Such practices included residents making treatment or medication errors "not due to a lack of knowledge or inexperience," failing to fully discuss treatment options and answer patient questions and discharging patients "because the team was too busy." Doctors generally serve one year as an intern and train for three years as residents after graduation from medical school. Dr. Julia Gore, chief resident at the Veterans Affairs hospital in the UW system, called the study a "snapshot" that doesn't fully describe the experience. "Sure, there definitely were times when I felt really tired and probably would say burned out," said Gore, in her third year as a resident. "After a few days off or after moving onto a different rotation, my response would be completely different." Even when fatigued, Gore said, she felt "very supported" by other residents and the attending physician on duty. Since doing the study, the UW has been working to reduce resident workloads by enforcing limits on the number of new admissions residents can take, and by mandating that they take at least one day off a week, Wipf said. In addition, the UW has begun monthly support groups for residents. "The profession is changing," Gore said. "It's OK to talk about it now."