To the Editor:
With a fractured health care system, global pandemic, and increased patient needs, many of us are questioning multiple aspects of our professional identity. As a pediatrician at a large, urban academic institution, I work with medical students and residents caring for some of the most vulnerable pediatric patients. In the October 2020 issue of Academic Medicine, Sternszus and colleagues address the clinical educator role in helping trainees develop the values and norms of our profession, much of which is rooted in the educator’s ideas of self-efficacy and clinical care. 1 However, increasing rates of burnout are hugely impacting these concepts and may be one of the biggest issues facing our professional identities as physicians, mentors, and trainees of all levels. 2,3
It is getting harder to be an effective and compassionate physician. Clinical educators cite the lack of control over workload and excessive time spent on electronic medical records as sources of increasing burnout and stress. 2 However, the source of our burnout is not just an individual issue, but a systemic issue rooted in the historical context of how we train doctors and how our health care system was created and financed. 3
Sternszus and colleagues highlight the importance of role modeling and engaging in difficult conversations to further develop a trainee’s professional identity. 1 We need to continue to improve mentorship and coaching models so we can have these difficult conversations about burnout with our trainees as well as time and support to practice our own self-care. Clinical educators must be taught and empowered to advocate for themselves. We can help them understand how burnout affects their personal and professional identities and develop strategies to create boundaries around their time and responsibilities so they can meet their obligations with self-compassion and empathy. As we advocate for systemic changes in all aspects of our health care system, we will effectively treat and prevent burnout in physicians and trainees.
1. Sternszus R, Boudreau JD, Cruess RL, Cruess SR, Macdonald ME, Steinert Y. Clinical teachers’ perceptions of their role in professional identity formation. Acad Med. 2020;95:1594–1599.
2. Norton J. The science of motivation applied to clinician burnout: Lessons for healthcare. Front Health Serv Manage. 2018;35:3–13.
3. Ludmerer KM. The development of American medical education from the turn of the century to the era of managed care. Clin Orthop Relat Res. 2004;422:256–262.