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ABSTRACT BACKGROUND: Moonlighting is a largely discussed, however under-explored, subject among physician residents. OBJECTIVES: To analyze the frequency of moonlighting and its related factors. DESIGN AND SETTING: This cross-sectional study enrolled medical residents from all geographical regions of Brazil. METHODS: A web-based structured closed-ended survey was applied that explored the frequency and type of moonlighting, residency programs characteristics, and psychological distress. The questionnaire was published on social networks. RESULTS: The completion rate was 71.4% (n = 1,419) and 37.7% were males aged 28.8 ± 3.2 (mean ± standard deviation) years, and 571 (40.2%) were post-graduate year (PGY) 1. There were residents from 50 medical specialties (the most common training area was clinical, 51.9%). A total of 80.6% practiced moonlighting, with an average weekly workload of 14.1 ± 9.4 h, usually overnight or in weekend shifts. Factors related to it were being PGY-2 or higher (adjusted odds ratio = 3.90 [95% confidence interval = 2.93-5.18], logistic regression), lower weekly residency duty hours (0.98 [0.97-0.99]), and a higher salary (1.23 [1.08-1.40]). In contrast, perception of a "fair/adequate" compensation was influenced by age (1.02 [1.01-1.02]), not being single (1.05 [1.01-1.10]), and residency duty hours (1.51 [1.22-1.88]). Depression, anxiety, diurnal somnolence scores, and work-personal life conflicts were not correlated with moonlighting status. CONCLUSION: Moonlighting frequency is high, and it is related to higher PGY, briefer residency duty hours, and the perception that remuneration should be higher. This study provides insights into the motivations for moonlighting and effort-reward imbalance.
ABSTRACT
Introducción: El burnout es un síndrome caracterizado por agotamiento emocional, despersonalización y bajo sentido de logro personal. Los médicos residentes de especialidad y subespecialidad constituyen una población de riesgo por la alta carga laboral y la interferencia con su vida personal. Nuestro objetivo fue evaluar la prevalencia de burnout y su asociación con variables sociodemográficas, en residentes de especialidad y subespecialidad de la Pontificia Universidad Católica de Chile (PUC). Métodos: Se realizó una encuesta electrónica a los residentes de especialidad y subespecialidad de la PUC, que incluyó el "Inventario de Burnout de Maslach" (22 preguntas divididas en 3 dimensiones). Se sumaron los puntos de cada dimensión y se clasificó a los residentes en riesgo de burnout al presentar altos índices de agotamiento emocional y/o despersonalización. El análisis estadístico incluyó un análisis univariado y multivariado. Resultados: 415 encuestas fueron contestadas (tasa de respuesta 86 por ciento). El 38,3 por ciento de los residentes cumplió criterios de burnout, con un 41,9 por ciento en residentes de especialidad y 24,1por ciento en residentes de subespecialidad. En el análisis por subgrupos, la mayor prevalencia se encontró en especialidades quirúrgicas (55,3por ciento). Los residentes extranjeros, los programas de especialidad (comparados con subespecialidad) y los programas de especialidades quirúrgicas se asociaron de manera independiente a burnout (OR 3,8 IC95 por ciento 1,4-10,5, p=0,01; OR 2,3 IC95 por ciento 1,3-4,1, p<0,01 y OR 1,7 IC95 por ciento 1,1-2,7; p=0,02, respectivamente). La carga laboral horaria no se asoció de manera independiente a burnout (p=0,19). Conclusión: Los residentes de especialidad y subespecialidad presentan una alta prevalencia de burnout. Adicionalmente, ser extranjero, el pertenecer a un programa de especialidad y los programas de especialidades quirúrgicas se asocian de manera independiente a burnout.(AU)
Introduction: Burnoutis a pathological syndrome characterized by emotional exhaustion, depersonalization and low sense of personal accomplishment. Residents from medical specialties and subspecialties constitute a population at risk for high work overload and interference in personal life. The aim of this study was to evaluate the prevalence of burnout and its associations with sociodemographic variables, in specialty and subspecialty residents of the Pontificia Universidad Católica de Chile (PUC). Methods: An electronic survey was answered by residents of specialty and subspecialty of PUC. It included the "Maslach Burnout Inventory" (which consists of 22 questions divided into 3 dimensions). The points of each dimension were added and burnout was defined as a high score on depersonalization or emotional exhaustion subscales. Statistical analysis included an univariate and multivariate analysis. Results: 415 surveys were answered (response rate 86 percent). 38.3 percent of residents met criteria for burnout, with a percentage of 41.9 percent for specialty residents and 24.1 percent for subspecialty residents. In the subgroup analysis, the highest prevalence was found in surgical specialties (55.3 percent). Foreign residents, medical residency programs (compared to sub specialization programs) and surgical programs were independently associated with burnout (OR 3.8 IC95 percent1.4-10.5, p=0.01; OR 2.3 IC95 percent 1.3-4.1, p<0.01 y OR 1.7 IC95% 1.1-2.7; p=0.02, respectively). There was no independent association between duty hours and burnout (p=0.19). Conclusion: Specialty and subspecialty residents have a high prevalence of burnout. Additionally, foreign residents, participation in a speciality residency (compared to subspecialties programs) and surgical residencies are independently associated to burnout. (AU)