Protecting the mental health of young clinicians

With greater focus on the wellbeing and mental health of clinicians, healthcare leaders and medical schools must be mindful of the stress on students and residents.

The majority of doctors are experiencing burnout, surveys have found. Six of 10 doctors said they experienced burnout, according to The Physicians Foundation’s 2023 Survey of America’s Current and Future Physicians. But the survey also shed light on disturbing findings among those expected to replenish the ranks of today’s doctors.

More than half of medical students (55%) said they felt hopeless, and nearly half of residents (43%) said they felt hopeless, according to the report.

Stefanie Simmons, the chief medical officer of the Dr. Lorna Breen Heroes’ Foundation, tells Chief Healthcare Executive® that the healthcare industry needs to think about the pressure it’s putting on aspiring doctors and nurses.

“I think we need to really as a profession, and not just the medical profession, but nursing and all the health professions, think about what do we need to graduate competent, skilled healthcare workers who are still whole people, and are able to have the emotional intelligence and the empathy to connect with patients in a meaningful way,” Simmons says.

At the same time, America is already facing a physician shortage. The Association of American Medical Colleges projects that the nation’s physician shortage could reach up to 86,000 by 2036. So the healthcare system can’t afford to drive away more doctors.

On the upside, younger adults are more likely to acknowledge struggles with their mental health, and they could be more open to getting assistance, she notes.

“There is a generational difference in willingness to seek mental health care and openness, particularly in those internal and external areas of stigma, in the newest generation of healthcare workers coming out of training programs and in training programs currently,” Simmons says.

At the same time, students have been facing greater academic pressure at an earlier stage than those who went to medical school years ago. Simmons recalls hearing from professors in medical school that they weren’t sure they could do it now.

“I always used to chuckle about that,” Simmons says. “Now, I feel the same way.”

Students face higher academic standards to get into medical schools, and expectations to excel in other ways.

“A lot of these young adults who are entering into medical and nursing school already have published papers, which was something that we weren't doing until residency,” Simmons says. “So the stress is getting pushed down, the stress of achievement is getting pushed down, younger and younger.”

“It’s really multifactorial, why we're seeing our trainees having levels of burnout,” she adds.

Simmons suggests that finding ways to reduce level of burnout in medical students and residents “is probably not earlier and more achievement.”

“It is probably more diverse experiences of humanity,” she says. “And I think that's that's the shift we're going to need to make if we want to have a sustainable healthcare professions training.”

Chip Baggett, executive vice president and CEO of the North Carolina Medical Society, suggests that medical schools must “meet the next generation, rather than the other way around.”

He also says that residency can’t be simply viewed as it was in the past.

“We can't do it just because this is the way we've always taught this way, or this is the way we've always done residency, or this is always the number of hours I've worked,” Baggett says.

He adds that long hours and skipping vacations can’t be viewed as badgers of honor.

“We’ve got to put some of that down and look at these kids and think, they're smarter than we give them credit for,” Baggett says. “We need to pay attention and incorporate that into the future learning because that future learning is going to accelerate really incredible patient outcomes, if we can figure out how to open our minds up to it.”

Simmons recalls working an internship before the implementation of rules setting a maximum work week of 80 hours for residents, and she completed an internship after the 80-hour maximum was imposed. With the 80-hour limit, she says, “I can tell you that your functioning and your ability to be a rational human being actually improves.”

“I think we have yet to find that sweet spot where we're really supporting and encouraging our trainees, while adequately preparing them to take on the rigors of healthcare professions,” Simmons says.

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Nursing leaders have also stressed the importance of giving less experienced nurses time to gain their footing. In a recent interview with Chief Healthcare Executive®, Jennifer Mensik Kennedy, president of the American Nurses Association, said employers should consider the experience - or lack of experience - in scheduling.

“Too many nurses with just a few months of experience “are expected to take the same workload as an experienced nurse,” Mensik Kennedy says. “So no one's got time to stop and think and that's where we get people who are like …. ‘I don't need to do this.’ And they leave.”

Mensik Kennedy also points to the need to provide mentoring opportunities for less experienced nurses. And that also involves ensuring veteran nurses have enough time to mentor their less experienced teammates. Too many nurses have unmanageable workloads, she said.

“The workload is such that nurses have to prioritize and ration care, to the point where there's not any slack in their day to be able to stop and help actually mentor,” Mensik Kennedy said. “And so the new grads and those younger nurses feel and see the extent to which the more experienced nurses are working and just don't have the time to help and help mentor them.”