Deciding what specialty to pursue is a key decision. It will impact your entire medical career. Although updates are possible, and you can punt by going into internal medicine and further specializing later, there are a number of factors to consider. Many choose specialties to deal with the mountain of debt accumulated in college/medical school. It’s a sad, but true reality. There are, of course, many other factors, such as support for work/life balance (or, in some situations, simply support for any life). Luckily, “residents” no longer need to live in the hospital. I remember my days at Montefiore hospital in Pittsburgh where folks pointed out the place were “residents” lived – 20 feet away from the hospital. Luckily, those days are gone, but the stress and challenge of residency are still quite real.
Stress and burnout can increase as clinical demands and responsibility increase. Learn how to identify and address issues of burnout through our immersive simulation.
I reviewed a helpful overview article by Dyrbye et al. in my blog Burnout in Different Residency Specialties.
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.
In making the decision, it’s helpful to gain a perspective on burnout and career regret among different specialties, such as:
- I think of giving up medicine for another career
- I regret my decision to have become a doctor
Why? Because many residents express career regret and risk of burnout persists into residency (and beyond). McManus et al. identified a simple means to assess career regret in their adaptation of the abbreviated MBI which included 2 questions that scored differently from personal accomplishment and thus might be markers of career regret.
McManus IC, Smithers Eleni, Partridge Philippa, Keeling A, Fleming Peter R. A levels and intelligence as predictors of medical careers in UK doctors: 20 year prospective study. BMJ. July 19, 2003;327(7407):139-142. [See Data Supplement: Questions on satisfaction with medicine and a medical career]
Since burnout varies by specialty, it’s worth investigating some articles that look at specific specialties. Of course, different programs will vary. So, carefully evaluate the specific program as well.
Surgery: Orthopedics, Surgical Oncology
- Saleh Khaled J, Quick James Campbell, Sime Wesley E, Novicoff Wendy M, Einhorn Thomas A. Recognizing and Preventing Burnout among Orthopaedic Leaders. Clin Orthop Relat Res. February 2009;467(2):558-565. doi:10.1007/s11999-008-0622-8.
- Shanafelt Tait. A Career in Surgical Oncology: Finding Meaning, Balance, and Personal Satisfaction. Ann Surg Oncol. February 2008;15(2):400-406. doi:10.1245/s10434-007-9725-9.
- McClafferty Hilary, Brown Oscar W, Medicine Section on Integrative, Medicine Committee on Practice and Ambulatory. Physician Health and Wellness. Pediatrics. October 1, 2014;134(4):830-835. doi:10.1542/peds.2014-2278.
- Blechter Batel, Jiang Nan, Cleland Charles, Berry Carolyn, Ogedegbe Olugbenga, Shelley Donna. Correlates of Burnout in Small Independent Primary Care Practices in an Urban Setting. J Am Board Fam Med. July 1, 2018;31(4):529-536. doi:10.3122/jabfm.2018.04.170360.
- Panagioti Maria, Geraghty Keith, Johnson Judith. How to prevent burnout in cardiologists? A review of the current evidence, gaps, and future directions. Trends in Cardiovascular Medicine. January 1, 2018;28(1):1-7. doi:10.1016/j.tcm.2017.06.018.
- Hlubocky Fay J, Rose Miko, Epstein Ronald M. Mastering Resilience in Oncology: Learn to Thrive in the Face of Burnout. Am Soc Clin Oncol Educ Book. 2017;37:771-781. doi:10.14694/EDBK_173874.
- Schapira Lidia, Meisel Jane Lowe, Srivastava Ranjana. For Our Patients, for Ourselves: The Value of Personal Reflection in Oncology. Am Soc Clin Oncol Educ Book. 2017;37:765-770. doi:10.14694/EDBK_175520.
The 2018 article by Dyrbye et al. is more up-to-date, but she previously published about data from 2011-12 which may offer general insight as well.
- Dyrbye Liselotte N, West Colin P, Satele Daniel, et al. Burnout Among U.S. Medical Students, Residents, and Early Career Physicians Relative to the General U.S. Population. Academic Medicine. March 2014;89(3):443. doi:10.1097/ACM.0000000000000134.
The article discusses differential rates of burnout among different categories of health professionals in different stages of training. My bias is that much as changed in medical education in 6-7 years and there is sufficient cross-sectional data on this topic that is more up to date. We hope that our Lift game-based learning experience can help contribute to the base of knowledge on burnout and help medical students identify and address situations of burnout in their own lives.