Journal of Rehabilitation Medicine 51-11 | Page 55
J Rehabil Med 2019; 51: 869–874
SHORT COMMUNICATION
BURNOUT AMONG SPECIALISTS AND TRAINEES IN PHYSICAL MEDICINE AND
REHABILITATION: A SYSTEMATIC REVIEW
Emma A. BATEMAN, MD 1,2 and Ricardo VIANA, MD 1,2
From the 1 Department of Physical Medicine & Rehabilitation, Schulich School of Medicine & Dentistry, Western University and 2 Parkwood
Institute, St Joseph’s Health Care, London, Ontario, Canada
Objective: Burnout, a state of emotional exhaustion
related to work or patient-care activities, is pre-
valent in all stages of medical training and clinical
practice. The syndrome has serious consequences,
including medical errors, poorer quality of care, sub-
stance abuse, and suicide. The aim of this study is
to evaluate the prevalence of burnout in Physical
Medicine & Rehabilitation (PM&R) specialists and
trainees.
Methods: Systematic literature searches were con-
ducted in MEDLINE, CINAHL and EMBASE for peer-
reviewed articles in English before March 2019 about
the prevalence of burnout amongst PM&R specialists
and trainees.
Results: This systematic review yielded 359 results.
Of these, 33 full-text records were reviewed; 5 met
the inclusion criteria: 3 surveys of PM&R specialists
and 2 of PM&R residents (total n = 1,886 physicians;
year of publication 2012–2019). Data extracted in-
cluded prevalence and severity of burnout and, if
available, risk or protective factors. Data were ana-
lysed using descriptive statistics. Incidence of bur-
nout ranged from 22.2% to 83.3% in trainees and
48% to 62% in specialists. Organizational and sys-
tem challenges were the primary risk factors for bur-
nout amongst specialists.
Conclusion: Emerging evidence positions physicians
in PM&R among the most likely to experience bur-
nout. Although there is limited literature regarding
PM&R specialists and trainees, the available evi-
dence suggests that more than half of physicians in
PM&R experience burnout.
Key words: Physical Medicine and Rehabilitation; burnout,
professional; physician impairment; residency; review.
Accepted Oct 2, 2019; Epub ahead of print Oct 14, 2019
J Rehabil Med 2019; 51: 869–874
Correspondence address: Emma A. (Ali) Bateman, Department of
Physical Medicine & Rehabilitation, St Joseph’s Health Care London,
Parkwood Institute, Main Building, PO Box 5777, Station B,,N6A 4V2,
Canada. E-mail: [email protected]
M
ore than half of all practicing physicians expe-
rience symptoms of burnout, a psychological
syndrome characterized by emotional and physical
exhaustion, reduced sense of personal accomplish-
ment, and depersonalization, in response to chronic
interpersonal stressors related to patient care (1, 2).
This psychological syndrome is prevalent in all sta-
LAY ABSTRACT
Professional burnout, emotional exhaustion and loss of
satisfaction with patient care affects doctors at all stages
of their career, from residency trainees to certified speci-
alists. Burnout is a critical emerging issue facing specia-
lists and trainees of all disciplines. Burnout in doctors is
linked to serious negative outcomes for patients, inclu-
ding higher rates of medical errors and poorer quality of
care. It is also linked to negative outcomes for doctors,
including substance abuse and suicide. Although burn
out is a serious problem, little is known about burnout in
specialists and trainees in Physical Medicine & Rehabili-
tation (PM&R). Historically, it was thought that doctors
in rehabilitation medicine were less likely to experience
burnout than doctors in other specialties. A systematic
review was conducted to understand if burnout is in fact
a problem for doctors in PM&R. It was found that more
than half of all rehabilitation doctors, including specia-
lists and trainees, experience burnout; a higher rate
than for non-rehabilitation doctors. Working in PM&R is a
unique risk factor for burnout among doctors. Important
next steps will be to understand what causes such high
rates of burnout and what can be done to help.
ges of medical training, including medical students
(28–45%), residents (27–75%) and practicing phy-
sicians (37–72%) (1, 3). Physicians and trainees who
report symptoms of burnout are at heightened risk of
committing medical errors, delivering poorer quality of
care, experiencing reduced career satisfaction, career
discontinuation, substance abuse, and suicide (4, 5).
As a crucial factor in the quality of care delivered by
physicians, burnout is therefore important not only to
the medical profession, but also to patients, healthcare
institutions, and societies. Importantly, burnout is both
preventable and treatable (5, 6).
Freudenberger first described burnout in 1974 in
the context of severe or prolonged stress in provi-
ding “healing” care to marginalized persons (6). In
1981, Maslach et al. characterized the 3 key tenets
of burnout: emotional exhaustion, depersonalization,
and a decreased sense of accomplishment, which are
captured in the Maslach Burnout Inventory (MBI), the
gold standard for assessing burnout (8). In the 44 years
since Freudenberger first described burnout, resear-
chers have attempted to elucidate risk and protective
factors for burnout. Although it is well-established that
physicians are at increased risk of burnout compared
This is an open access article under the CC BY-NC license. www.medicaljournals.se/jrm
Journal Compilation © 2019 Foundation of Rehabilitation Information. ISSN 1650-1977
doi: 10.2340/16501977-2614