Burnout in internal medicine physicians: Differences between residents and specialists

Background
Burnout poses a substantial problem for physicians' well-being and for the quality of health care. The role of workload in comparison to subjective work characteristics has been rarely studied. The purpose of this study was to explore the associations of burnout with workload and subjective work characteristics in internal medicine specialists and residents.

Methods
A cross-sectional study using an anonymous mailed survey was used. Some 103 specialists and 143 residents participated in the study. Burnout was measured using the Maslach Burnout Inventory. Subjective work characteristics included perceived job demands in terms of time pressure, mental effort and emotional labor. Workload was assessed in terms of average number of hours worked per week.

Results
Emotional exhaustion in medical specialists was only predicted by perceived job demands [odds ratio 3.7 (CI 1.7–7.9), P < 0.001]. Emotional exhaustion in medical residents was only predicted by emotional labor [odds ratio 1.9 (CI 1.2–3.0), P = 0.003]. Depersonalization among medical specialists was only predicted by emotional labor [odds ratio 2.7 (CI 1.1–6.7), P = 0.032], while depersonalization among medical residents was only predicted by number of hours worked per week [odds ratio 1.1 (CI 1.1–1.2), P = 0.007].

Discussion
Perceived working conditions were more important than workload in explaining the variance in burnout. In addition, burnout in medical specialists and residents was linked to different characteristics of their working environment.