BCMSMedicalRecordSpring2017 - 4

editor's comments

Antidotes for Burnout:
Collegiality, Camaraderie, Community

I
Lucy J. Cairns, MD
Editor

In the Fall 2016 edition of this magazine, Dr. Heath Mackley addressed the very high
prevalence of burnout among practicing physicians that has been well documented in
multiple surveys. One dictionary definition of burnout describes it as "exhaustion of
physical or emotional strength, usually as a result of prolonged stress or frustration." The
three indicators often used to measure burnout are 1) emotional exhaustion associated with
work-related stress, 2) feelings of detachment toward patients, and 3) a low sense of personal
accomplishment. Burnout in a physician has been associated with reduced quality of patient
care, increased risk for substance abuse, and suicidal ideation.
The stressors associated with a medical career begin to accumulate long before the
M.D. or D.O. degree is conferred, as all of us in the profession are aware. As soon as a
young person fixes on the goal of becoming a physician, the pressure is on to produce a
stellar academic record while simultaneously constructing a resume filled with impressive
extracurricular accomplishments. The following statement found on the admissions website
of the Sidney Kimmel (formerly Jefferson) Medical College sums it up in stark terms:
"Admission is competitive: Each year, the Committee on Admissions selects a class of 225
students from an applicant pool of approximately 10,000." Ouch.
For the successful applicants who enroll in medical school, however, the stress is just
beginning. In addition to the grueling academic workload and periodic must-pass licensing
exams, the transition from classroom to bedside is fraught with opportunities for failure
and self-doubt as students grow into their new role. And for the roughly three-quarters
of medical students carrying student loan debt, that burden grows heavier each year,
creating another source of stress. As you will learn in our feature article, for students who
will graduate this spring this burden amounts to $300,000 or more for 9% of students
graduating from public medical schools, and for 20% of graduates of private medical
schools. Double ouch. You don't need to do a survey to conclude that students with this
much debt worry about their futures, and since debt of this magnitude takes many years to
pay off, it will continue to affect these students during their careers.
Since doctors earn relatively high incomes, it is reasonable to ask why anyone outside
the profession should care about medical student debt. The answer lies in recognizing
the consequences that extend far beyond those for the individual making those monthly
payments for decades. As noted above, stress is the major factor causing burnout in
practicing physicians, affecting their ability to provide optimal care to patients. Physicians
suffering from burnout are more likely to retire early or to leave patient care for alternate
career paths perceived as less stressful. A medical student watching his or her loans mount

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Table of Contents for the Digital Edition of BCMSMedicalRecordSpring2017

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