Burnout and Educational Debt Affect Medical Knowledge Among IM Residents (measured by exam scores)

Doctors are not impervious to stresses of daily life. Physician distress is common and has been associated with negative effects on patient care.

This JAMA study of internal medicine residents used data collected during 2008-2009 Internal Medicine In-Training Examination (IM-ITE). Participants were 16,000 IM residents, representing 74% of all eligible US internal medicine residents - approximately 7700 US medical graduates and 8500 international medical graduates (IMGs).

Quality of life was rated “as bad as it can be” or “somewhat bad” by 15% of residents.

Burnout, emotional exhaustion and depersonalization were reported by 51%, 46%, and 29% of residents, respectively.

Burnout was less common among international medical graduates than among US medical graduates (45% vs 59%),

Greater educational debt was associated with the presence of at least 1 symptom of burnout (61% vs 44%; for debt greater than $200 000 relative to no debt).

Residents reporting QOL “as bad as it can be” and emotional exhaustion daily had exam scores 2.7 points and 4.2 points lower than those with QOL “as good as it can be” and no emotional exhaustion, respectively.

Residents reporting debt greater than $200,000 had exam scores 5 points lower than those with no debt.

Suboptimal QOL and burnout were common among IM residents. Burnout was associated with higher debt and was jess frequent among international medical graduates (IMGs).

Low QOL, emotional exhaustion, and educational debt were associated with lower IM-ITE scores.

References:

Quality of Life, Burnout, Educational Debt, and Medical Knowledge Among Internal Medicine Residents. JAMA, 2011;306(9):952-960. doi: 10.1001/jama.2011.1247
Stress overdose for doctors. Star Tribune.
Image source: OpenClipArt.org, public domain.

Brain networking among musicians

From Deutsche Welle:

When musicians play, what is happening inside their brains? Scientists at Berlin's Max Planck Institute for Human Development have discovered that while performing together, their neurological activity goes into a kind of synchronization mode - almost as though they were connected by a wireless network.

Medical problems among prisoners

From a recent review in The Lancet:

More than 10 million people are incarcerated worldwide, and this number has increased by one million in the past decade.

Some of the major medical problems include:

- Mental disorders and infectious diseases are more common in prisoners
- High rates of suicide in prison
- Increased mortality on release

High risk groups among prisoners:

- women
- prisoners aged 55 years and older
- juveniles

References

The health of prisoners. The Lancet, Volume 377, Issue 9769, Pages 956 - 965, 12 March 2011.
“A very severe physical trial”. The Lancet, Volume 377, Issue 9769, Page 876, 12 March 2011.
It’s fashionable to treat social problems as if they were diseases. Can incarceration be thought of as disease? asks BMJ http://goo.gl/R6BNp

Comments from Twitter:

Courtney J Blair, MD ‏ @AllergistBlair: Thank you. I have a CVID pt going to prison for embezelment, this may help to get home incarceration.