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Burnout during a doctor's early years in practice should not be considered a rite of passage, and younger clinicians should be protected from physical and mental exhaustion by their older colleagues, according to a Perspective piece published by the .

Senior, influential and experienced doctors must lead action to protect their younger colleagues from debilitating burnout, say聽the authors. Professor Michael Baigent, Professor of Psychiatry at in Adelaide, and a board member of , and Dr Ruth Baigent, a general practitioner, wrote that older doctors may look back 鈥渙n their pressurised junior years through rose-coloured glasses and see [burnout] as a rite of passage鈥�.

Burnout is described via three concepts: exhaustion, cynicism (role negativity, feeling callous and detached) and professional efficacy (self-evaluation of competence and achievement).

鈥淲hen the doctor has symptoms severe enough to also qualify for a mental illness, they are likely to be diagnosed; burnout is regarded as an aetiological factor. If the doctor falls short of a clinical diagnosis, burnout becomes the explanation and problem,鈥� wrote Baigent and Baigent.

鈥淎lthough not a diagnosis, the concept of burnout nevertheless resonates. Most doctors recognise it in a colleague鈥檚 uncharacteristic irritability, drowning fatalism and loss of belief in professional identity and efficacy.鈥�

beyondblue survey

In the beyondblue national mental health survey of doctors and medical students, published in October 2013, it was reported that 32% of Australian doctors had high levels of exhaustion and 35% had high levels of cynicism, two of three domains of burnout, the third being loss of belief in professional identity and efficacy.

鈥淭he beyondblue survey found young doctors to be at greatest risk, with those aged under 30 years most likely to report burnout (high exhaustion, 48%; high cynicism, 46%),鈥� Baigent and Baigent wrote.

鈥淭here was a steady reduction across older age bands, with 11% of doctors aged over 61 years reporting emotional exhaustion.

鈥淧erhaps those who burn out, get out 鈥� of the profession. Also, in the life cycle of the doctor, the levels of external evaluation and autonomy also change favourably with years of experience 鈥� In burnout research generally, younger age is a more consistent variable than personality in determining burnout,鈥� they wrote. Avoiding burnout, they said was a 鈥渟hared responsibility鈥�.

鈥溾�楨pidemic鈥�, 鈥榗risis鈥� and 鈥榰rgent need鈥� are words accompanying discussions of burnout and doctor suicides. Yet, despite this bombardment, there has been no sustained approach to achieve an effective national response.

鈥淚t is too easy to blame the system and, likewise, for the system to blame the doctor. A certain amount of work-hardening and experience is necessary, but perhaps older doctors look back on their pressurised junior years through rose-coloured glasses and see it as a rite of passage.

鈥淚s it not time for senior, influential and experienced doctors to lead action on behalf of our young apprentices?鈥� they concluded.

Image credit: 漏stock.adobe.com/au/vchalup