Researchers to Study Severity & Impacts of Burnout on Alberta Physicians, Residents and Medical Students

Burnout is a serious risk for many professionals, as they struggle to balance intense workplace pressures and endless social or family obligations with their own personal needs.

01 March 2019

Burnout is a serious risk for many professionals, as they struggle to balance intense workplace pressures and endless social or family obligations with their own personal needs.

Indeed, studies show that Physicians experience the crippling symptoms of burnout - emotional exhaustion, chronic overstress, depersonalization, shrinking levels of personal accomplishment - at even higher rates than most people.

According to a 2012 study of nearly 7,300 Physicians in the U.S., 45.8% reported at least one symptom of burnout, with the highest rates recorded among front-line practitioners in areas like emergency medicine.

"One study I read cited physician burnout rates as high as 85%, with most averaging around 70%. Whatever the actual numbers are, they are very, very high," says Dr. Adam Abba-Aji, Associate Clinical Professor in the Department of Psychiatry at the University of Alberta.

Dr. Abba-Aji, Co-Investigator of a new study on Physician burnout in Alberta, says one of the serious effects of burnout is that it increases the likelihood of medical errors.

"There are several studies that have related Physician burnout and wellness to medical errors. As a matter of fact, more than 50% of medical errors have been indirectly or directly related to Physicians' wellness or burnout," he says.

Since most studies on medical doctors' burnout rates and the related risks of medical errors have been done in the U.S., Europe or Asia, it's still unclear how Physicians stack up on these metrics in Alberta.

Dr. Abba-Aji is a member of a team of researchers who hope to answer that question. Dr. Vincent Agyapong, a Clinical Professor in the Department of Psychiatry at the U of A and Edmonton Zone Clinical Section Chief, Community Mental Health, with Alberta Health Services (AHS), is the study's Principal Investigator.

Co-Principal Investigators include Dr. Robert Mallet, a Psychiatry Resident at the U of A who will focus on the impact of burnout on Physicians; Dr. Marianne Hrabok, a medical student at the University of Calgary whose key focus is burnout rates among medical students; and Dr. Esther Kim, a Psychiatry Resident at the U of A who will examine burnout rates among Residents.

The study's team of Co-Investigators also includes: Dr. Chantal Moreau, Associate Clinical Professor of Psychiatry, U of A; Dr. Liana Urichuk, Adjunct Associate Professor of Psychiatry, U of A; Dr. Shireen Surood, Manager, AHS Addictions & Mental Health (AMH) Decision Support Unit; Dr. Maryana Kravtsenyuk, Director, Psychiatry Residents Research, U of A; Wesley Vuong, Evaluations Coordinator, AHS AMH Decision Support Unit; Dr. Daniel Li, Associate Clinical Professor, U of A Department of Psychiatry; Dr. Izu Nwachukwu, Assistant Clinical Professor, Department of Psychiatry, U of C; and Dr. Melanie Marsh, Assistant Clinical Professor of Psychiatry, U of A.

"A large number of Physicians and Residents have struggled with burnout without necessarily even knowing it. So this study will attempt to identify those silent features of burnout so Physicians, Residents and students are more aware of it, and what symptoms to look for," says Dr. Abba-Aji.

"The goal of our study is to look at the prevalence of burnout among students, doctors and Residents. That is number one. The second key question we will look at is, how does this group perceive the impact of burnout on their personal and professional lives? And the third question is, what interventions can we recommend? These are the three main objectives of the study."

Researchers will use the Maslach Burnout Inventory, a short questionnaire-based tool designed to measure the symptoms and severity of burnout.

"It examines questions like: What are your goals? What have you achieved? How difficult is it for you to achieve your goals? What are your coping strategies? What do you use to cope? What sort of support do you have? What is your relationship with others? Are you having problems sleeping? Do you feel sad? Do you get angry easily? These are some of the things we'll be looking at."

The researchers hope to obtain responses from a minimum of 777 of Alberta's 1,148 medical students; at least 959 of the province's 1,594 medical Residents; and 1,961 or more of Alberta's 10,674 Physicians.

"We will be working with the Royal College of Physicians and Surgeons of Canada. They have all the contact names of Alberta's Physicians, Residents and medical students. So we'll be working through them and sending out the questionnaires by regular mail. We had thought about sending electronic questionnaires but we've decided to use printed and mailed questionnaires," says Dr. Abba-Aji.

Other study Collaborators include: the College of Physicians and Surgeons of Alberta's Physician Wellness Program; the Alberta Medical Association's Physician and Family Support Program; the U of A's Faculty of Medicine & Dentistry, Office of Advocacy & Wellbeing; and the U of C's Department of Medicine, Physician Wellness & Vitality Program.

The Project Coordinator for the study is Alicia Yang, Physician Resources Coordinator, AHS Edmonton Zone; the study sponsor is Dr. Daniel Li, AHS's Interim Zone Clinical Department Head - Addiction and Mental Health.

"Once we get the results we intend to analyse them from a variety of perspectives, including by medical specialty, by gender, by the level of support respondents have outside or inside the hospital, and by years of work experience. This should give us a very broad-based picture of the differences and the degrees of burnout across various demographics," he explains.

"Ultimately, our intentions are to come out with recommendations that could be taken directly by Physicians, as well as recommendations to the universities so they can include resilience training in the curriculum for medical students. For the Residency programs the study findings might help to guide them on how to manage frequency of calls, the needs for protected times or the length of work shifts for Residents."

For Physicians, the recommendations might focus on how to identify the symptoms of burnout or how to access resources you may need to address it. As for the symptoms, they can vary widely, he notes.

"If you didn't file your taxes on time it may be a sign of burnout. If you've had two or three patient relations complaints about your professionalism, it may be due to burnout. Or if the amount of alcohol you've been drinking has increased it may be due to burnout. So we'll highlight all the factors that people need to watch for."

For Dr. Abba-Aji, burnout isn't just an abstract concept. It's a reality. He relays a story about his own experience with burnout.

"I was here at University of Alberta Hospital covering for a colleague who was away at the time. So I saw all my own patients at UAH, and then I went to a clinic and finished there. After that I came back here and did my rounds. Then I went into a meeting," he recalls.

"It was a very long day and I was really tired. It was about 7 p.m. and I was driving home. I went through two red lights without noticing them, so I parked my car, called my wife and I said I'd be home late. I took a walk, and went into Tim Hortons for some hot chocolate and a rest before I drove the rest of the way home. I was burnt out."