A recent survey of young physicians in the Netherlands reported that one in five (19%) participants self-reported symptoms of burnout, according to De Jonge Specialist, an association of young physicians. Compared to the U.S., where I trained and worked as a physician, the rates are similar, despite differing medical education systems and financing, and other labor laws. This seems revealing of a universal culture of medicine.
During my first training year in Internal Medicine, while finishing a 30-hour hospital shift ending on New Year’s Day, I sunk into that rock-bottom feeling of exhausting the little energy I had left to stabilize two of my patients who experienced medical emergencies simultaneously, with the support of two senior residents. Already sleep-deprived and hungry, I stressfully made it through that morning, then coordinated specialist consultations and other care plans for a co-resident to follow up during the day. Then I headed home, beginning my new year with tears and a sense of utter depletion.
Such occupational exposure of physicians to high-stress circumstances is inevitable: when forced to pull on every last bit of mental and physical reserve, repeatedly doing this in a sometimes dysfunctional system, burnout is a natural consequence. Unfortunately, physicians are also at higher risk, compared to the general population, of mental health and substance use disorders, suicidal thoughts and behaviors.
While there are differences between working conditions for residents in the U.S. and the Netherlands, there are aspects of medical training culture that appear similar, based on the recent report and U.S. reports. Resident duty hours easily exceed those allowed by labor laws, including additional unofficial hours worked; personal and family needs are expected to be secondary to medical training; and a false culture of strength is propagated, leading individual residents to suffer in silence.
Consequently, it is no surprise that burnout rates are comparable between Dutch and American systems. Physicians at any stage of their career have not traditionally been considered a vulnerable population. However, their uniquely increased risk for burnout and mental health disorders calls for rethinking how we can best heal our healers.
Tiffany I. Leung, Assistant Professor at FHML