Letters to the Editor
To the Editor:
Burnout is a well-known problem in medical education. We know that burnout affects about half of medical students, is linked to lower empathy scores, and can lead to mental health problems. We know that burnout is detrimental to quality of care and to the doctor–patient relationship. We also know that many distressed students do not seek help because of stigma, personality traits, and other factors, which can limit the benefits of student support services. As I consider all this, I conclude that one way to tackle the problem of burnout is to teach burnout prevention skills in the mainstream medical curriculum. These skills should be taught as abilities that promote quality patient care and professionalism, just like any other important medical skill.
How can we medical educators teach this? We can review ways to diminish the negative effects of the stress response, encourage self-awareness, and discuss common personality traits in physicians that predispose to burnout. We can promote having a sense of control over one's environment to positively affect well-being and engage students in problem solving to “change what they can change.” We can candidly discuss burnout rates in students, residents, and physicians and the impact of burnout on role modeling by faculty and on the “hidden curriculum” of the U.S. medical education system. We can use analogies: Our medical culture, socialization, and education system are like a riptide; physicians are caught in the current of self, societal, and academic expectations, demands on their time, and the values of the “hidden curriculum,” all of which seriously challenge physician well-being. Like swimming perpendicular to a riptide to prevent drowning, embracing physician self-care in our medical culture to prevent burnout is counterintuitive but crucial.
At my school, we have already included the above topics in our curriculum to bolster the numerous student support services offered. Students tell us that our burnout prevention classes are helpful and important. But mostly, they challenge us: Why don't we do something about this “riptide”? It is not enough to teach students how to cope with a faulty system. They want it fixed!
Professionalism and quality of care are receiving much attention lately, and medical schools are taking measures to promote these issues. Correspondingly, we need systemic administrative changes in medical schools and teaching institutions nationwide to develop and support a culture of well-being at all stages of medical education and beyond. This is the surest way to prevent burnout in medical school and will go a long way to produce a resilient physician workforce that can deliver the quality of care and professionalism that our society rightfully expects.
Chantal M.L.R. Brazeau, MD
Associate professor of psychiatry and family medicine, New Jersey Medical School, Newark, New Jersey; firstname.lastname@example.org.