Medical educator burnout

For academic and other teaching physicians and health professionals, the dysfunctional educational environment contributes to burnout as well as the toxic sick care system of systems. They are not alone. According to one recent analysis, over half of teachers surveyed are considering quitting.

It’s still too soon to determine to what extent the COVID-19–era Great Resignation has impacted the higher education faculty: there’s no national survey to reflect current faculty departures or the reasons behind them. Bureau of Labor Statistics data do show a decline in postsecondary instructor employment between?May 2020?and?May 2021?(1,369,930 versus 1,340,560, respectively), but 2022 data aren’t yet available. The American Association of University Professors’ annual faculty salary survey?report?shows a slight 0.6?percent dip in overall faculty head counts between fall 2019 and fall 2021, with bigger declines at associate and master’s degree–granting institutions, but of course this doesn’t reflect faculty departures happening now. There is also another possible explanation for the 2021 numbers: pandemic-era layoffs, which are still happening on some campuses.

In this survey study, the perceived stressors associated with work-life integration were higher in women than men, were highest in women with children, and have been exacerbated by the COVID-19 pandemic. The association of both gender and parenting with increased perceived work-life stress may disproportionately decrease the long-term retention and promotion of junior and midcareer women faculty.

According to a study, 8.6 percent of clinical M.D.?faculty reported intentions of leaving their institutions within the subsequent 1-2 years1.?Results varied by department; faculty in radiology, otolaryngology, and pediatrics reported the lowest intentions of leaving (2.9, 3.7, and 4.6%, respectively)1. Although viewed as an important calling, academic medicine comes at a price.?As a group, academic physicians make on average 13 percent less than their non-academic counterparts1.?Of those who do work in academic settings, up to 38 percent will leave academia within 10 years1.

?According to these researchers, burnt out employees show that there are urgent problems to be addressed at the heart of any organization. But burnout is a management and organizational issue, not a physical or mental health issue, so promoting self-care won’t usually help employees recover. The chronic job stressors that cause burnout can emerge from several kinds of?mismatches, which reflect a bad fit between the job and basic human needs such as competence, belonging, and psychological safety. Such mismatches can occur in six core areas, which apply to all people, regardless of their job: workload, control, reward, community, fairness, and values. Improving matches — helping people find fulfillment within an area of work life — can nudge employees away from burnout. It is a leader’s job to run a collaborative process with employees to address the persistent mismatches that employees experience at work. Leaders should take five critical steps to design better job matches for their employees.

Such mismatches can occur in?six core areas, which apply to all medical educators:

• Workload
• Control
• Reward
• Community
• Fairness
• Values

They suggest these remedies:

1. Ask for input on mismatches.?

2. Pivot to consider a range of positive matches.

3. Begin with attainable goals.?

4. Use design principles.?

5. Build in progress checkpoints.?

I would add:

6. Change the culture of medical education

7. Reform the curriculum Stop educational malpractice.

8. Create a value proposition that does the job students and other stakeholders want you to do

9. Find a cure for academentia

10. Stop believing that anybody at an academic medical center is willing and able to teach and that they don't have to get paid to do it. While some might see it as a calling driven by intrinsic motivation, many don't have the number on their iPhone contact list so the call gets deleted.

We need to PISS on burnout wherever we see it, not just in the clinic, but the classroom too.

Arlen Meyers, MD, MBA is the President and CEO of the Society of Physician Entrepreneurs

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