Training in Neurology: Identifying and addressing struggling colleagues in the era of physician burnout

Abstract

Careers in medicine are rewarding, but fraught with challenges that can contribute to burnout, depression, and substance abuse. Burnout is classically defined as chronic workplace stress that has not been managed successfully, and is measured by the Maslach Burnout Inventory, which addresses (1) emotional exhaustion, (2) feelings of cynicism and detachment (depersonalization), and (3) a sense of low personal accomplishment. 1 Serial surveys demonstrate that neurologists are more likely than the average physician to experience burnout. 1 Over half of neurologists and neurology trainees in the United States report at least one dimension of burnout. 2,3

Education Research: Impact of Burnout on Neurology Residents and Research Fellows in Europe

“…We showed that night shifts are another independent risk factor for burnout, thus corroborating the evidence emerging from previous 12,16,27 and highlighting the importance of appropriate working schedules 28 limiting work-related fatigue. 21 Weekly working hours were significantly higher among responders in burnout as compared with engaged participants.…”

“…Burnout and depression are 2 distinct nosographic entities, but they can both exist in presence of a dysfunctional work environment. 27,29 This combination might be particularly worrisome given the increased risk of suicide 28 which represents a leading cause of mortality among young physicians especially during the first years of residency. 30 Burnout profiles were distributed in a peculiar pattern according to the geographic region with engaged participants working predominantly in Western Europe, while overextended participants were working in Southern Europe, thus indicating some protective or distressful factors intrinsic to the specific neurology residency programs and workplace regulations.…”

Neurology Education in 2035

“…Simulation is a promising assessment format not only for both technical skills, such as lumbar puncture and brain death determination, but also for less easily assessed skills such as communication and monitoring peer wellness. [62][63][64] We predict that there will be an ongoing lively debate about what is expected of every graduate of a neurology residency program. For example, it is unclear whether every graduate would be considered qualified and competent to interpret EEG or EMG.…”

“…Simulation is a promising assessment format not only for both technical skills, such as lumbar puncture and brain death determination, but also for less easily assessed skills such as communication and monitoring peer wellness. 62-64…”