Career and Life Planning Guidebook for Medical Residents

In a meta-analysis published in The Lancet, West, Dyrbye, Erwin and Shanafelt identified 2,617 articles of which 52 met inclusion criteria. Their results indicated that meaningful reductions in physician burnout could be achieved through both individual- focused and organizational strategies. 22 "In my work with thousands of burned-out doctors, the most common cause of burnout is the way most doctors choose their first job. Here is the most common mistake: You focus on getting them to choose you ... just like we did in medical school and residency. When you are looking for your first job it is important to turn the tables. It is not about whether theywill choose you. This time it is about whether this job is a good match for your ideal practice.” – Dike Drummond, MD www.thehappymd.com F I E L D N O T E S PERSONAL CONSEQUENCES TO BURNOUT Broken relationship Alcohol/drug addiction Depression Anxiety Sleep disturbance and fatigue Early retirement/career change Marital dysfunction/divorce Suicide There is a general tendency to overestimate the con- tribution of individual factors. As previously noted and defined by Maslach, burnout is primarily or- ganizational in origin and should be addressed as such. Job dissatisfaction relates to a loss of meaning in the work being performed. The converse is that a loss of meaning in the work one is doing leads to job dissatisfaction. It is a truly vicious cycle that, once established, can be difficult to break. While Frankl thought that a feeling of meaninglessness was part of the human experience, he also felt it could be pathogenic and lead to depression, aggression and addiction. These essentially came secondary to what he referred to as an ‘existential vacuum’. Maslach and Leiter referred to this phenomenon Physician Burnout 39 WWW.PHYSICIANCAREERPLANNING.COM