Special Session 4 - Trainers and Trainees Well-being

Over recent years there has been increasing recognition of the importance of “keeping the doctor healthy”. This has never been more important than in the past year when we have face the additional stress of the COVID pandemic 
This presentation will
- discuss why it is imperative to have a healthy medical workforce
- outline some of the reasons for medical professionals having higher rates of poor mental health compared to the general population 
- share examples about how the challenges have been addressed in various locations. 
- examine the extra impact of the COVID pandemic on “staying well for work”
- suggest pathways forward and future initiatives that may lead to improved doctor wellbeing 

Physician burnout is being increasingly recognized worldwide as a serious threat to medical practice across all specialties with increasing prevalence. Burnout is a spectrum of clinical syndrome that was first categorized into 3 dimensions by Maslach as emotional exhaustion, depersonalization, and a low sense of personal accomplishment. It has been reported that the incidence of physician burnout is rising in Western countries, but studies on the well-being and burnout in physicians in Asia are relatively limited. We performed a territory-wide cross-sectional study using internationally-validated standardized questionnaires on all residents and young fellows (within 10 years of fellowship) in Hong Kong between January and May 2019 to determine the prevalence and risk factors for burnout, their job satisfaction levels, and their health-related quality of life. 746 doctors responded to the survey, of which 514 (53.9% female; 46.1% male) completed the survey. The average number of hours worked per week were 53.5±14.8 hours. 28% of respondents were somewhat or very dissatisfied with their current job positions, and 2.7% planned to stop practising medicine in the next 12 months. The mean Copenhagen Burnout Inventory (CBI) scores were 59.6, 57.3 and 49.0 for personal-, work-related and client-related burnout, respectively. The top 3 cited sources of stress were from clinical duty (17.6%), patient load (16.9%), and professional examinations (12.6%). 4.1% of respondents expressed suicidal ideation or attempts within the past 2 weeks of completing the survey. 1.5% of respondents consumed alcoholic beverages 4-7 times per week, and 0.8% were current smokers, while 55.8% and 40.7% of respondents had not performed any vigorous or moderate exercise in the past 7 days. The finding of this preliminary study showed that a substantial level of stress and physician burnout existed in Hong Kong, and future studies to see how these can be addressed are warranted.

The World Medical Association’s Declaration of Geneva, recited and vaguely remembered by medical students and young doctors in place of the Hippocratic Oath these days, says:


“I will attend to my own health, well-being, and abilities in order to provide care of the highest standard”.


How the two segments of this pledge of unarguable logic actually play out with and against each other in daily life and professional practice is difficult to unravel; what is being increasingly recognised though, is that doctors are not always very good at looking after themselves and each other, with their own wellness becoming an issue of growing concern worldwide for its intrinsic importance to the individuals and impact on patient care and organisational effectiveness.


Two studies found that somewhere between 30 to 60% of physicians in Hong Kong suffered from burnout, characterized by a low sense of personal accomplishment, emotional exhaustion, cynicism, and depersonalization.[1-2] Clinicians in their senior years may also experience unwelcome changes in their own physical health, cognitive function, self-efficacy, and clinical performance. All these call for our attention and a concerted effort in devising the appropriate preventive, monitoring, and remedial measures. 


Specialist trainers and trainees, their wellbeing and competency and what they do with it, constitute the very reason for the Academy’s existence. This paper explores some of the strategies that the Academy may adopt in dealing with physician burnout and in supporting clinicians in their advanced years of practice, renewing the pledge that we must look after ourselves and each other so to provide the best care for our patients.