Mitigating Burnout for Internal Medicine Program Directors

Mitigating Burnout for Internal Medicine Program Directors

Institutions offering internal medicine residency programs have the opportunity to reduce the barriers faced by directors of these programs to help mitigate burnout.

An internal medicine residency program director must ensure that interns and medical residents acquire the knowledge, skills, and attitudes necessary to practice their chosen specialty independently and competently.

What else do residency program directors have on their plate?

  • Organize and implement courses
  • Evaluate trainee performance
  • Provide Meaningful Instructions
  • Serve as important role models
  • Defend the interests of trainees
  • Ensure compliance with program requirements
  • Cultivate and maintain relationships with management and faculty
  • Define program objectives and goals
  • Research opportunities to improve the quality of care

It’s no wonder, then, that the Alliance for Academic Internal Medicine says that one-third of internal medicine (IM) residency program (PD) directors are burnt out. Nor is it surprising that less than half of those who were PDs in 2012 still held that job in 2016. A survey of IM program directors in 2020, published in the Journal of Graduate Medical Education, showed that 45% of respondents had considered quitting in the past year. Although the study concluded that the prevalence of burnout before and after the onset of the pandemic was similar, it indicated that PDs with supportive leadership were less likely to feel burnt out.

The Association of American Medical Colleges estimates that there will be a shortage of 37,800 to 124,000 doctors within 12 years! Given this dire prediction, pressure is on medical schools and residency programs to train and graduate as many qualified physicians as possible. However, the challenges of managing internal medicine rotations and residencies should not push program directors out the door.

Let’s take a look at how MI residency programs have evolved, what keeps DPs awake at night, and how some of the burdens they face can be reduced or eliminated.

Wider knowledge base, more requirements and regulations

As the study and practice of medicine continues to transform at lightning speed, the training of aspiring doctors has understandably evolved as well. The American Journal of Medicine® notes that IM residents worked in hospitals more than 90 hours per week for two of three years of residency in 1980. Yet while the three-year program remains the same all these years later , residents now have to digest a lot more information – from more drugs being used for common illnesses to new testing and treatment modalities.

What other changes are being made to internal medicine residency programs?

  • Program requirements have increased exponentially,
  • Hours of work reduced by mandate, decree and legislation,
  • Outpatient warrants have expanded excessively relative to inpatient requirements,
  • Sub-specialties have become both more complex and increasingly attractive, and
  • Higher percentages of graduate residents choose careers in the hospital setting.

And what has changed for IM residency program directors? Their list of responsibilities, large and small, continues to grow, as does the number of people and groups to which they are accountable. Dr. Amy Eddy, director of the internal medicine residency program at Spokane Teaching Health Center, puts it simply, “It’s like going to medical school again, drinking from a fire hose.”

Busy days, sleepless nights for residency program directors

While Dr. Eddy enthusiastically admits that she cares about her residents and is invested in their success, she concedes that program directors are wearing more hats every day: “We are the ones whose responsibility s stop for any situation or problem. She cites everything from institutional requirements to ACGME to CMS billing as “always evolving, always getting more complex.”

Dr. Eddy also notes that PDs often find there is no clear path to navigate when problems arise. “A lot of people don’t understand what a residency program is, the ups and downs and the needs of higher medical education — that can add to the challenge. DPs have many masters to please who may not communicate with each other and sometimes have different priorities than ours. We are always looking to navigate the system to meet our needs. »

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