What specialty do you want to go into? As a 3rd year medical student, a tough decision awaits. Are you passionate about a certain area of medicine? Has your focus changed since you started medical school? What if you make the wrong decision?
Career regret can lead to burnout. Learn how to identify and address issues of burnout through our Simulation.
A Sept 2018 publication by Dyrbye et al. provides a helpful guide to the relationship of specialty choice and the risk of burnout by following medical students into their residency programs and looking at burnout in different specialties. [See: Dyrbye Liselotte N, Burke Sara E, Hardeman Rachel R, et al. Association of Clinical Specialty With Symptoms of Burnout and Career Choice Regret Among US Resident Physicians. JAMA. September 18, 2018;320(11):1114-1130. doi:10.1001/jama.2018.12615.]
If you are curious about burnout or career regret in your future or current residency, then the article is well worth a look. The study provides an overall average burnout rate of 45.2% and an assessment of burnout rates by specialty (varying from 34.7% for Pathology to 63.8% for Urology). They also looked at variation in career regret and found an average rate of 14.1%. The participant numbers were too low for many specialties, but where the pool was at least 100 respondents the rate of career regret varied from 8.9% for Family Medicine to 20.6% for Anesthesia/Critical Care Medicine. With nearly half of all residents on average experiencing burnout and almost 1 in 7 expressing career regret, the rates are sobering.
Unfortunately, the article does not provide much guidance regarding why one specialty is more affected than another. Is it hours worked? Patient mix? Cognitive challenge? Institutional support? Hostile/supportive supervisors? Or perhaps it’s a combination of many of these factors. These are the important questions to answer since they define what may cause individual differences in burnout.
The study also looked at the impact of different demographic factors including sex, race, ethnicity, marital status, parental status, income, educational debt, and birth country on both burnout rates and career regret. It is surprising that no clear relationship was shown in most cases. A difference was seen in Hispanic respondents regarding career regret, but less so in terms of burnout. The etiology of that difference is unclear, but certainly worthy of investigation.
Even though demographic factors appear to play a minimal role in burnout, regret differences do indeed exist between individuals. It is thus essential to identify the institutional and patient care factors associated with burnout. We need actionable data. Do wellness programs in medical school lead to less burned out residents who do not regret their career? We don’t know. Medical practice depends on robust prospective research that measures the impact of interventions on outcomes. Physician burnout research needs it as well.
We are setting out to address the issue of burnout and career regret through game-based learning. In Lift, medical students are immersed in a virtual reality environment where they practice coping strategies to improve resilience. The Lift role-playing experience delivers targeted, realistic narratives and hands-on scenarios to deepen medical student understanding of how to address and overcome burnout during game-play and beyond.
