Physical activity, quality of life, and burnout among physician trainees: the effect of a team-based, incentivized exercise program.

Department of Urology, University of Minnesota School of Medicine, Minneapolis, MN.
Mayo Clinic Proceedings (Impact Factor: 5.79). 12/2013; 88(12):1435-42. DOI: 10.1016/j.mayocp.2013.09.010
Source: PubMed

ABSTRACT To prospectively study the effects of an incentivized exercise program on physical activity (PA), quality of life (QOL), and burnout among residents and fellows (RFs) in a large academic medical center.
In January 2011, all RFs at Mayo Clinic in Rochester, Minnesota (N=1060), were invited to participate in an elective, team-based, 12-week, incentivized exercise program. Both participants and nonparticipants had access to the same institutional exercise facilities. Regardless of participation, all RFs were invited to complete baseline and follow-up (3-month) assessments of PA, QOL, and burnout.
Of the 628 RFs who completed the baseline survey (59%), only 194 (31%) met the US Department of Health and Human Services recommendations for PA. Median reported QOL was 70 on a scale of 1 to 100, and 182 (29%) reported at least weekly burnout symptoms. A total of 245 individuals (23%) enrolled in the exercise program. No significant differences were found between program participants and nonparticipants with regard to baseline demographic characteristics, medical training level, PA, QOL, or burnout. At study completion, program participants were more likely than nonparticipants to meet the Department of Health and Human Services recommendations for exercise (48% vs 23%; P<.001). Quality of life was higher in program participants than in nonparticipants (median, 75 vs 68; P<.001). Burnout was lower in participants than in nonparticipants, although the difference was not statistically significant (24% vs 29%; P=.17).
A team-based, incentivized exercise program engaged 23% of RFs at our institution. After the program, participants had higher PA and QOL than nonparticipants who had equal exercise facility access. Residents and fellows may be much more sedentary than previously reported.

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    ABSTRACT: Background: Burnout is prevalent in doctors and can impact on job dissatisfaction and patient care. In medical students, burnout is associated with poorer self-rated health; however, it is unclear what factors influence its development. This study investigated whether health behaviours predict burnout in medical students. Methods: Medical students (n 0356) at the Universities of St Andrews and Manchester completed an online questionnaire assessing: emotional exhaustion (EE), depersonalisation (DP), personal accomplishment (PA), alcohol use, physical activity, diet, and smoking. Results: Approximately 55% (54.8%) of students reported high levels of EE, 34% reported high levels of DP, and 46.6% reported low levels of PA. Linear regression analysis revealed that year of study, physical activity, and smoking status significantly predicted EE whilst gender, year of study, and institution significantly predicted DP. PA was significantly predicted by alcohol binge score, year of study, gender, and physical activity. Conclusions: Burnout is present in undergraduate medical students in the United Kingdom, and health behaviours, particularly physical activity, predict components of burnout. Gender, year of study, and institution also appear to influence the prevalence of burnout. Encouraging medical students to make healthier lifestyle choices early in their medical training may reduce the likelihood of the development of burnout. B urnout is a measure of physical and psychological exhaustion and mental distress catalysed primarily by occupational and professional demands. It is characterised by heightened levels of emotional exhaus-tion (EE) and depersonalisation (DP) (described as emo-tional indifference and the dehumanisation of the client or patient), and a decreased perception of personal ac-complishment (PA) (1). Burnout is commonly found in individuals working within human services and recent studies estimate the prevalence of burnout in American doctors to be around 40% (2, 3), although some have found it to be as high as 76% in internal medicine residents (4). The cause of burnout is complex and unclear; however, it is becoming increasingly evident that many students begin to experience burnout in medical school, with prevalence rates of around 49% in medical students in the USA and 28Á61% in Australia (5). Burnout and stress are symptomatically similar, with burnout attributed specifically to occupational stressors (6). McManus and colleagues (7) proposed that there is a cyclical relationship between stress and EE, suggesting that heightened levels of stress and poor coping strategies may be key contributors in the development of burnout. Medical school is challenging and previous work suggests that a number of factors, from academic pressures and educational debt, to personal life events, gender, learning environment and exposure to human suffering, contri-bute to heightened levels of stress and poor mental health in medical students, including burnout (8Á11). Addi-tional research has also shown that maladaptive lifestyle and health behaviours as a means of coping with stress are prevalent among young people and university stu-dents, with studies suggesting associations between stress, alcohol consumption (12, 13), unhealthy diets (14, 15), and reduced physical activity (16). Generally, it has been shown that health beliefs and behaviours are sub-optimal in European university stu-dents (17). In addition, alcohol consumption has been found to be higher in medical students than in age-matched samples in the general population (18, 19) and
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