For Claire Lawlor, MD, a recent clinical fellow in pediatric otolaryngology at Harvard University/Boston Children’s Hospital in Massachusetts, becoming an otolaryngology resident at Tulane University in New Orleans “changed my life drastically.”
Explore this issue:August 2018
“The work hours are long and there’s tremendous pressure put on you by your program, and that you put on yourself,” said Dr. Lawlor, who is also chair of the American Academy of Otolaryngology–Head and Neck Surgery (AAO–HNS) Section for Residents and Fellows-in-Training. “There is very little time for hobbies or the interests that used to define you. There’s a real loss of your former self-identifiers. Plus, friends and family who are outside your field may not always understand—you miss weddings, family events, holidays, and, depending on the program you’re in, it can be hard to go home to visit when family is sick. The time commitments are vast.”
Such environments can foster burnout, a physical or mental collapse brought on by too much work or stress. And burnout at the early stages of a medical career can cause feelings of hopelessness about medicine and/or self, and lead to less empathy toward patients.
Burnout among physicians is growing. A 2015 study found that dissatisfaction with work and life balance among physicians increased from 2011 to 2014, with nearly 60% of the 6,880 physicians surveyed reporting they weren’t happy with their workload and personal life balance (Mayo Clin Proc. 2015;90:1600–1613).
It’s happening to earlier-career medical professionals, too. In a 2012 study of 1162 medical students surveyed annually from 2007 through 2010, researchers found that empathy levels decreased as students advanced through four years of medical school (Med Teach. 2012;34:305–311).
“It’s horrible—these students come to be healers and we squish empathy out of them,” said Sian Cotton, PhD, professor and director of the Center for Integrative Health and Wellness at the University of Cincinnati College of Medicine in Ohio.
Medical School Efforts
Burnout is discussed more openly today than even five years ago, said Dr. Lawlor. “There’s an increasing focus on it in medical school and training, in part due to a lot of well-publicized suicides of both medical students and residents. I think it is garnering the attention it deserves.”
Aviad Haramati, PhD, is the director of the Center for Innovation and Leadership in Education, co-director of the CAM Graduate Program, and a professor in the division of integrative physiology at the Georgetown University School of Medicine in Washington, D.C. Through the mind–body medicine program, the medical school offers students stress management skills training, such as meditation and guided imagery, and other programs to foster self-awareness and self care. Since 2002, the program has trained faculty within Georgetown and other institutions.