By the year 2030, there will be a projected global shortage of 18 million healthcare workers (19). In Israel particularly, reduction in the availability of healthcare personnel is expected over the coming years, especially physicians and in certain specialized domains, i.e., anesthesia (20) as well as in the state periphery (21–23). To address this expected deficit, several strategic measures may be implemented: It was repeatedly suggested to offer financial and other incentives to attract physicians to areas of need, re-hiring retired physicians that would return to work, but sufficient solutions are still missing.
Beyond the mere deficit in numbers, there are major concerns of the escalated burnout process of healthcare workers in general and of physicians in particular (5). The COVID-19 pandemic has augmented these challenges to an unprecedented level across the globe (24). This crisis has placed an overwhelming burden on healthcare facilities. Health care professionals faced intense pressure, resulting in significant mental health impacts and burnout due to heavy workloads, limited resources, and increased exposure risks. This eventually caused many healthcare professionals to retire early or consider leaving their professions (24).
This highlights the critical need for workforce planning, better support mechanisms for healthcare professionals, and a better understanding of the extensive impacts of the COVID-19 pandemic on healthcare systems, especially in relation to burnout and future workforce shortages among senior physicians and residents.
Upon addressing healthcare professionals’ burnout, the means for quantifying the process should be addressed. Several earlier publications associated burnout with the sense of dissatisfaction amongst physicians (6, 9). Therefore, in the current study we decided to measure and quantify interns’ satisfaction as a surrogate marker for their burnout process. We addressed these challenges with action plans accompanied by research. Our decision was based on earlier publications stressing the need for organizational interventions aimed at struggling burnout and stress among trainee physicians (25). The results presented in this article show that addressing three essential components in the young physicians’ experiences are beneficial: endowing continuous, personal consultation along with professional empowerment and a continuous process of appraisal. Our 18-months’ follow-up results did not come to us by surprise: we knew that the biggest challenge would be found in the surgery departments and indeed, the improvement was the most significant in these interns’ placements.
Surgery departments are the most challenging to young medicine-school graduates since they face them with their largest gap in competencies, therefore, the level of empowerment and sense of competence are exceptionally low to begin with. Also, the more practical / executive nature of these departments is significantly more stressful for young physicians. Rozenberg et al. (26) suggested, as part of what they named as “Surgical intern wellness initiative”, the usage of a twice monthly reflective questionnaire. This is somewhat equivalent to our ongoing appraisal plus continuous consultation meeting in the current study.
Other, non-surgical departments had relatively high scores to begin with (such as internal medicine and pediatrics). High initial scores for theses departments created a ceiling effect in the Likert-type questionnaire that we used. Considering the ceiling effect, one must differentiate between departments that have high initial scores and did not improve much and departments that had low initial scores and did not show major improvement (such as the emergency medicine department). Such departments with low initial scores and small improvements might be suitable for development of other interventions in the future.
Based on the responses provided to the two open-ended queries in this study, it is worth noting that "long working hours" significantly contribute to interns’ low levels of satisfaction, undoubtfully accelerating burnout. This negative factor was clear at all hospitals’ departments and is in alignment with previous reports and organizational knowledge (27).