Introduction: Burnout is highly prevalent among residents and is associated with negative outcomes for patients, organizations, and physicians. Balint groups have been shown to be an effective strategy to alleviate physicians' burnout. The purpose of this study was to examine the effectiveness and feasibility of Balint groups in preventing burnout among residents in training programs in China.Methods: 36 resident physicians in their first year of residency at a comprehensive hospital in China were randomly assigned to two groups. Physicians in the intervention group participated in 2 lectures and 10 Balint sessions for 6 months, while participants in the control group were placed on a waitlist for future Balint sessions. All 36 participants completed burnout and job satisfaction measures pre and post-intervention.Results: The mean burnout subscale scores for EE and DP decreased, and the scores for PA and job satisfaction increased after Balint group participation. However, paired t-test results revealed there were no statistically significant differences between pre and posttest scores for EE (t = −1.323, p = 0.203), DP (t = −0.727, p = 0.477), PA (t = 0.716, p = 0.484, and job satisfaction (t = 0.282, p = 0.781) for the intervention group. For the control group, the burnout subscale scores for EE (t = 2.312, p = 0.034) and DP (t = 2.898, p = 0.019) increased, and there were statistically significant differences between pre and posttest. PA (t = −0.717, p = 0.483) and job satisfaction (t = −0.241, p = 0.812) scores decreased although there were no significant differences seen between the pre and posttest. Independent t-test results demonstrated statistically significant differences in scores for EE (t = −2.662, p = 0.013) and DP (t = −2.433, p = 0.020) between intervention and control group. However, there were not statistically significant differences between groups for scores in PA (t = 1.013, p = 0.318) and job satisfaction (t = 0.367, p = 0.716). All 18 participants in the intervention group reported that Balint groups were helpful and that they would be willing to attend future sessions. Overall satisfaction with the Balint group program was over 80%.Conclusion: Balint groups are an efficacious, feasible, standardized method of preventing resident burnout. Residents in China may benefit from Balint group implementation in residency training programs.

Chronic pelvic pain in women can arise from many causes and often results in significant declines in function and quality of life. A systematic approach for evaluating patients and initiating a management plan are recommended in the primary care setting. Comprehensive management strategies may include medication, pelvic physical therapy, and behavioral interventions.

Objective: Transgender patients enter the health care system with a unique set of strengths and challenges. While facing a cancer diagnosis can be an overwhelming process for patients and their loved ones, questions have to be addressed and particular services have to be provided to create a supportive environment for members of the transgender community. The purpose of this article is to provide a systematic literature review of the existing research on cancer care for transgender patients.Method: Four electronic databases were searched, including PubMed, Wed of Science, CINAHL, and EMBASE. Overall, 23 articles published from 1968 to 2012 met the established criteria and were included in this study.Results: While biomedical components of cancer care for transgender patients, such as diagnostic and treatment strategies, were discussed, the review revealed an overall paucity of literature pertaining to the examined subject, exhibiting a particular lack in consideration of psychosocial and spiritual domains of care.Conclusion: Largely, researchers have focused on biomedical components of cancer care for transgender patients. To gain a deeper, and more inclusive understanding of how the transgender cancer patient population experiences care, further research is needed on psychosocial and spiritual aspects of the cancer experience.

Background and Objectives: There are several trends compelling physicians to acquire team-based skills for interprofessional care. One underdeveloped area of team-based skills for physicians is integrated behavioral health (IBH) in primary care. We used a Delphi method to explore what skills were needed for residents to practice integrated behavioral health. Methods: We conducted a literature review of IBH competencies and found 41 competencies across seven domains unique to physicians. Using a modified Delphi technique, we recruited family medicine educators to rate each competency as “essential,” “compatible,” or “irrelevant.” We also shared findings from the Delphi study with a focus group for additional feedback. Results: Twenty-one participants (12 physicians, nine behavioral health providers) completed all three rounds of the Delphi survey resulting in a list of 21 competencies. The focus group gave additional feedback. Conclusions: Participants chose skills that required physicians to share responsibilities across the entire care team, were not redundant with standard primary care, and necessitated strong communication ability. Many items were revised to reflect team-based care and a prescribed physician role as a team facilitator. Next steps include determining how these competencies fit with a variety of medical providers and creating effective training programs that develop competency in IBH.

Patients who present with medically unexplained illnesses or medically unexplained symptoms (MUI/S) tend to be higher utilizers of health care services and have significantly greater health care costs than other patients, which add stress and strain for both the patient and provider. Although MUI/S are commonly seen in primary care, there is not sufficient information available regarding how providers can increase their level of confidence and decrease their level of frustration when working with patients who present with MUI/S. The goal of this article is to present findings from a qualitative phenomenology study, which highlights medical residents' experiences of caring for patients with MUI/S and the personal and professional factors that contributed to their clinical approaches. Results from these studies indicate that residents often experience a lack of confidence in their ability to effectively treat patients with MUI/S, as well as frustration surrounding their encounters with this group of patients.