Burnout and work-privacy conflict - are there differences between full-time and part-time physicians?

How we achieve satisfaction in training - A German-wide survey on preferred training conditions among trainers and trainees for board certification in gastroenterology

BACKGROUND

a majority of resident physicians in Germany are not satisfied with their training conditions. However, training satisfaction is important for physician retention and patient care. Although federal and state laws define the general training regulations and conditions, considerable variability still exists concerning their implementation in the healthcare units. Little is known about the expectations concerning training for gastroenterology board certification by trainers and trainees in Germany. This lack of data hinders discussion on and improvement of training in gastroenterology in Germany.

AIM

assessment of preferred training conditions among trainers and trainees for board certification in gastroenterology in Germany.

METHODS

an anonymous, voluntary survey consisting of single- and multiple-choice questions utilizing the Likert scale and fill-in responses was circulated to all members of the German Society for Digestive and Metabolic Diseases (DGVS - Deutsche Gesellschaft für Gastroenterologie, Verdauungs und Stoffwechselerkrankungen), as well as through the student council mailing lists of all German medical schools. The survey aimed to assess the consent regarding the ideal implementation of training regulations for gastroenterology board certification. Department heads, senior physicians, board-certified physicians, and outpatient-care physicians were classified as trainers and residents and students as trainees. Subgroups defined by place of work, age, gender, professional position, employment status, and parental status were investigated.

RESULTS

958 responses were included in the final analysis. We found a broad consensus among trainers and trainees on most aspects of our survey. Considerable differences were seen in items on part-time work, overtime, protected time for research, and advanced endoscopy training.

CONCLUSION

the broad consensus seen in this survey is indicative of a shared vision for training conditions among trainers and trainees. However, the areas of dissent identified in this survey may assist trainers to better understand the expectations of trainees. Furthermore, this survey creates a sound basis upon which training conditions for board certification in gastroenterology in Germany can be discussed and improved.

Physician Burnout: Evidence-Based Roadmaps to Prioritizing and Supporting Personal Wellbeing

Current literature validates the magnitude of physician burnout as a complex challenge affecting physicians, patients, and healthcare delivery that mandates science-informed intervention. Physician burnout affects both individual practitioners and patient care delivery. Interventions, defined as roadmaps, to prioritizing and supporting personal wellbeing encompass organizational, individual, and moral injury, with virtually no consensus on optimal approaches. The purpose of this conceptual review is to present evidence-based innovative insights on contributing factors, mitigation, and designing adaptive systems to combat and prevent burnout. Science-informed policy initiatives that support long-term organizational changes endorsed by both leadership and institutional stakeholders are keys to sustaining personal wellbeing and ending burnout.

Working time reduction, mental health, and early retirement among part-time teachers at German upper secondary schools - a cross-sectional study

Objective

Many secondary school teachers work part-time in order to cope with the high workload and to remain as healthy as possible until regular retirement. However, due to the acute shortage of teachers, the increase in the teaching obligation for part-time teachers (PTT) has become a topic of discussion in Germany. Whether a reduction in teaching hours is associated with benefits for mental health has not yet become evident. Therefore, this study investigated the relationship between the real working hours of PTT and their mental health as well as individual pension prognosis.

Methods

The cross-sectional study included 5,905 PTT at German upper secondary schools (female proportion: 81%, average age: 44 ± 9 years) who logged their working hours over four weeks. Four part-time groups (PTG) were formed based on the proportion of a full-time position worked: maximum (<100-90% = PTGmax - reference group - 17%), high (<90-75% = PTGhigh - 34%), medium (<75-50% = PTGmed - 40%) and low (<50% = PTGlow - 9%) teaching commitment. These groups were compared in terms of their average weekly working hours, mental health (inability to recover, risk of burnout) and predicted retirement age.

Results

The contractually agreed working time is exceeded to a relevant extent for PTT. The extent of unpaid overtime increases significantly the lower the teaching obligation is and lies on average between -0.4 (PTGmax) and 7.3 (PTGlow) hours/week. A reduction in teaching hours is neither related to the mental health of teachers nor to their decision to retire early (42%) or regularly (58%). However, predicted retirement is mainly explained by mental health status, gender and age (variance explanation: 24%, OR of predictors: maximum 2.1). One third of PTT reported inability to recover, 47% burnout symptoms and 3% a burnout syndrome.

Conclusion

Mental health is also a risk for PTT; reducing teaching hours alone does not improve it. However, good mental health increases the chance of regular retirement. Therefore, instead of a legal obligation, PTT should be encouraged to increase the number of teaching hours voluntarily in order to counteract the general shortage of teachers.

Beyond the Hype: (How) Are Work Regimes Associated with Job Burnout?

Job burnout affects countless workers and constitutes a major issue in working life. Prevention strategies such as offering part-time options and shorter working weeks have been widely advocated to address this issue. However, the relationship between shorter work regimes and burnout risk has not yet been investigated across diverse working populations applying validated measures and frameworks for job burnout. Building on the most recent operationalisation of job burnout and the seminal job demands-resources theory, the purpose of the current study is to investigate whether shorter work regimes are associated with lower burnout risk and whether the job demands-resources explain this association. To this end, a heterogenous sample of 1006 employees representative for age and gender completed the Burnout Assessment Tool (BAT) and Workplace Stressors Assessment Questionnaire (WSAQ). Our mediation analyses yield a very small but significant indirect association between work regimes and burnout risk through job demands, but no significant total or direct association between work regimes and burnout risk. Our result suggests that employees in shorter work regimes experience slightly fewer job demands, but are equally prone to developing burnout as their full-time counterparts. The latter finding raises concerns about the sustainability of burnout prevention that focuses on mere work regimes instead of the root causes of burnout.