It is an ethical imperative for the program director—as well as all faculty members—to be aware of the burnout phenomenon, and to always be observant for signs of its occurrence. Better yet, programs need to institute, or strengthen, preventive programs that directly impact and mitigate the issues that can lead to burnout in residency. This may well begin with faculty training on the burnout phenomenon, both for their own welfare and to enable them to recognize the signs and symptoms (perhaps in themselves as well as in the residents). Faculty recognition of the insidiousness of professional burnout will provide a better sense of why it is important to prevent and/or ensure early mitigation of these representative personal difficulties—physical and emotional exhaustion, detachment from social interactions, poor patient communications, difficulties with personal relationships, decreased self-confidence and self-worth, mistakes in patient care, and signs of clinical depression, to name a few.
Explore this issue:April 2017
Residency programs that are successful in addressing burnout in residents have become proactive with respect to surveillance, recognition, prevention, mitigation, reassessment, and ongoing monitoring. These programs have also put into place a wide range of strategies that prepare residents for the challenges and disappointments that characterize a surgical career, while emphasizing the benefits and joys of being a caring, compassionate, and competent otolaryngologist. Teaching coping mechanisms for stress, emphasizing proper diet and exercise, facilitating appropriate rest time and vacations away from training, promoting faculty-resident mentoring programs that allow for discussions and encouragement, and offering the opportunity to take advantage of mental and physical wellness programs provided by the academic institution will all be salutary methodologies.
While early recognition of the signs of resident burnout is a prerequisite for mitigation, perhaps the most important effort is to prevent it, if possible, or at least to reduce its risk in a residency training program. Effective prevention or mitigation seems to involve two major elements—systems/environmental control and attention to the person. Regarding the former, many education programs on physician burnout are available, and these are excellent awareness tools for both residents and faculty—viewed and discussed as a group. Residency training is clearly not too early to learn about this issue, which may affect over 40% of practicing otolaryngologists to varying degrees during their clinical lifetime. Resident work hours are monitored for a reason—to prevent exhaustion and cognitive deterioration. A training program is responsible for monitoring the workload of residents and making changes if a systemic problem is identified.