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Research

Assessing the mental wellbeing of next generation general practitioners: a cross-sectional survey

Fanny Lindemann, Zsofia Rozsnyai, Brigitta Zumbrunn, Julia Laukenmann, Regula Kronenberg and Sven Streit
BJGP Open 2019; 3 (4): bjgpopen19X101671. DOI: https://doi.org/10.3399/bjgpopen19X101671
Fanny Lindemann
1 MD Candidate, Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
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Zsofia Rozsnyai
2 Deputy Head of Career Development, Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
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Brigitta Zumbrunn
3 Resident, Department of General Internal Medicine, Bern, Inselspital, Bern University Hospital, Switzerland
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Julia Laukenmann
4 Resident, Primary Care Practice, Lenzerheide, Switzerland
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Regula Kronenberg
5 Resident, Department of General Internal Medicine, Lucerne, Cantonal Hospital Lucerne, Switzerland
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Sven Streit
6 Head of Career Development, Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
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  • ORCID record for Sven Streit
  • For correspondence: sven.streit@biham.unibe.ch
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    Figure 1. Crude comparison of mental wellbeing in young and future GPs, and by level of education (total n = 475, due to missing data n = 28)
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    Figure 2. Stress factors of students, residents, and early-career GPs sorted by frequency. Participants responding (very) often are shown as red bars, the rest as grey bars.

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    Table 1. Baseline characteristics of participants, stratified by level of education
    CharacteristicsOverall n = 503Medical students n = 46 (9.8%)Residents n = 228 (48.3%)GPsan = 196 (41.7%)P value
    Sex, n (%)
     Female352 (75.1)43 (93.5)168 (74.0)141 (71.9)0.009
    Mean age, years (SD) 33.6 (5.7)25.5 (2.0)31.7 (3.8)38.1 (4.3)<0.001
    Language, n (%) 0.016
     German430 (91.5)43 (93.5)200 (87.2)187 (95.4)
     French40 (8.5)3 (6.5)28 (12.3)9 (4.6)
    Civil status, n (%) <0.001
     Single104 (22.2)19 (41.3)63 (27.6)22 (11.3)
     With partner167 (35.6)27 (58.7)92 (40.4)48 (24.6)
     Married198 (42.2)0 (0)73 (32.0)125 (64.1)
    Children, n (%) 198 (42.3)0 (0)62 (27.2)136 (70.1)<0.001
    Part-time work, n (%) 246 (52.8)14 (32.6)b 67 (29.4)b 165 (84.6)<0.001
    • 33 (6.5%) participants did not specify if they were students, residents, or GPs and were therefore only analysed in the overall column.

    • aGPs early in their career. bTotal n = 466, due to missing data.

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    Table 2. Stress and sequelae of stress of future and early-career GPs, stratified by level of education
    Characteristics of stress, n (%)Overall n = 470aMedical students n = 46 (9.8%)Residents n = 228 (48.3%)GPsbn = 196 (41.7%)P value
    Stress level, high or very highc 229 (48.7)19 (41.3)114 (50.0)96 (49.0)0.56
    Not enough private time, often or very oftenc 210 (44.7)15 (32.6)128 (56.1)67 (34.2)<0.001
    Thinking of leaving job, often or very oftenc 37 (7.9)1 (2.2)24 (10.5)12 (6.1)0.08
    Current risk of burnoutd 70 (14.9)4 (8.7)45 (19.7)21 (10.7)0.016
    Ever experienced burnout or exhaustion or depression 79 (16.9)3 (6.5)39 (17.3)37 (18.9)0.13
    • aTotal n = 470 due to missing data. bGPs early in their career. cAsked in respect of the last 2 weeks; recorded on a 5-item Likert scale (very often–never), dichotomised in two groups (often or very often versus sometimes or rarely or never). dMeasured in five categories and dichotomised based on Edwards et al. 23

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    Table 3. Final multivariable regression model: the effect of level of education on mental wellbeing (n = 463). Adjusted for all covariates in the table
    Participant characteristicAdjusted difference in mental wellbeing (95% CI)P value
    Level of education
     Student0.5 (-1.8 to 2.7)0.69
     Residentreference
     Early-career GP2.2 (0.7 to 3.8)0.005
    Sex
     Female-1.7 (-3.1 to -0.2)0.022
     Malereference
    Children
     Yes2.0 (0.5 to 3.5)0.008
     Noreference
    Part-time work
     Yes-1.6 (-3.2 to 0.1)0.062
     Noreference
    Not enough private time
     Often or very often-4.5 (-5.8 to -3.2)<0.001
     Sometimes, rare, neverreference
    • Reading example: having children (compared with not having children) means a higher score in WEMWBS of 2.0 points (95% CI = 0.5 to 3.5 points).

    • Sample size here n = 463 is smaller due to missing data in 8% of the sample.

    • View popup
    Table 4. Support requests for optimisation and long-term preservation of mental wellbeing
    FrequencyMain themeExamples mentioned
    19%Improving work–life balance
    • family-friendly working environment

    • acceptance and promotion of part-time work

    • less shift-work

    • improving childcare

    19%Reduction of administrative tasks
    • assistance from non-medical staff

    • use of electronic medical records

    • efficient computer programs

    11%Shorter working hours and adherence to breaks
    • no overtime

    • adherence to breaks

    10%Improvement of education and training
    • regular mentoring at all training levels

    • improving feedback culture, dealing with mistakes

    • close supervision

    • improving teaching

    10%Workload reduction
    • more time for individual patient

    • reduction of high work demands

    • measures against the lack of family doctors

    6%Good team atmosphere and collegial exchange
    • regular exchange among colleagues

    • organised case discussions

    6%Recognition
    • by superiors, colleagues, and environment

    5%Salary adjustment
    • possibility of calculating work in the absence of patients (preparation and follow-up time)

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Assessing the mental wellbeing of next generation general practitioners: a cross-sectional survey
Fanny Lindemann, Zsofia Rozsnyai, Brigitta Zumbrunn, Julia Laukenmann, Regula Kronenberg, Sven Streit
BJGP Open 2019; 3 (4): bjgpopen19X101671. DOI: 10.3399/bjgpopen19X101671

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Assessing the mental wellbeing of next generation general practitioners: a cross-sectional survey
Fanny Lindemann, Zsofia Rozsnyai, Brigitta Zumbrunn, Julia Laukenmann, Regula Kronenberg, Sven Streit
BJGP Open 2019; 3 (4): bjgpopen19X101671. DOI: 10.3399/bjgpopen19X101671
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Keywords

  • general practitioners
  • mental wellbeing
  • mental health
  • training
  • residency
  • resilience
  • surveys and questionnaires

More in this TOC Section

  • Translating primary care to telehealth: analysis of in-person consultations on diabetes and cardiovascular disease
  • Primary care physicians’ perceptions of social determinants of health recommendations: a qualitative study
  • Variation in laboratory testing for patients with long-term conditions: a longitudinal cohort study in UK primary care
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