Half of Spain's young doctors suffer from burnout syndrome
24-hour shifts with hardly any breaks and the overload of care have led to widespread emotional exhaustion and low self-esteem
The Spanish medical association (OMC) warns that more than half of young doctors suffer from burnout, which is characterised by severe emotional exhaustion, altered perception of reality and a drop in self-esteem and self-fulfilment. Burnout leads to psychological and physical problems and a marked decline in work performance.
This serious problem, which above all affects resident doctors who work in hospitals and health centres while specialising in a specific field, not only puts their health at risk but also "the safety of patients" and "the very sustainability of the public healthcare system". These junior doctors carry the bulk of the emergency services and night shifts. "Emotional exhaustion and lack of rest are becoming the norm for a generation called upon to sustain the health system," the OMC says.
One in four have had to take sick leave, two out of three suffer from insomnia and 38% take anxiolytics or abuse alcohol
The 'Ikerburn: From Vocation to Burnout' report is the first comprehensive study of burnout among young doctors and its causes. The report outlines the results of three years of analyses, with the participation of 1,400 young doctors. It seeks to "break the silence surrounding the mental health of healthcare professionals".
The results of the study describe an alarming reality. It is not that more than half of young Spanish doctors have one or only a few symptoms of burnout. Instead, the study concludes that they present the full clinical picture of the syndrome. Some 79% of the doctors interviewed suffer from exhaustion, 84% show depersonalisation symptoms (as if they perceive reality from outside their body and mind) and 63% experience low personal fulfilment (low self-esteem and job dissatisfaction).
One in four young doctors have had to take time off work due to emotional and physical exhaustion; two out of three suffer from insomnia; four out of ten (38%) have resorted to stimulants such as anxiolytics or alcohol to alleviate their problem; and up to 85% of them admit to having a decreased libido as a result of the strong emotional exhaustion.
Overburdened care and precariousness
According to the OMC, this is a "structural" problem brought about by unhealthy working conditions and, above all, by a medical training model "that makes its professionals ill". Among the factors that cause the greatest psychological wear and tear and exhaustion are the 24-hour shifts that medical residents, after which 43.6% do not even get a rest day during the regular work week when those shifts fall on weekends. Added to this is the generalised lack of rest, the overload of care they endure and the precariousness of their contracts, with practically 100% temporary employment. All of these factors "violate European regulations on working time and have a direct impact on patient safety".
Moreover, the problem is not one-off or localised in one centre or area of the country. The high prevalence of the syndrome affects all medical specialties and all regions, although it is most critical in surgical and hospital areas and is 24% more frequent among women. The report warns that "attending to the mental health of young doctors is not a luxury, it is a requirement for guaranteeing patient safety and quality of care". It calls for urgent structural reforms of training and working conditions, "to halt the deterioration of professional well-being and prevent the drain of medical talent".
The report, which will soon be published by a high-impact scientific journal, makes a series of recommendations to public administrations, with the aim of reversing the situation. Among them are complying with labour regulations and ensuring rest periods after on-call shifts; strengthening the supervision of medical residents and distributing the workload more evenly; promoting the comprehensive care programme for sick doctors (Paime), which is currently known to only 40% of residents; creating psychological well-being and work-life balance programmes, with particular attention to female doctors; and establishing a national burnout observatory to monitor the evolution of the problem.
