Burnout in junior doctors in palliative care - a qualitative study on culture, identity, and systems

Abstract

Abstract Context: Burnout in palliative care practitioners (PCPs) is a significant problem. Junior doctors (JDs) who may be particularly vulnerable have largely been under-represented in existing literature. Objectives: The is an exploratory qualitative study that investigates the influence of the culture of palliative care (PC) and systemic policies on the risk of burnout for JDs at the National Cancer Centre Singapore (NCCS). The data presented will guide strategies that foster wellbeing for junior staff.. Methods: A total of 13 JDs who have completed at least one month of their rotation at the Division of Supportive and Palliative Care at NCCS between 2020 to 2022 were recruited. Individual semi-structured interviews each lasting about one hour were completed and thematic analysis was used to analyse the data collected. Results: A total of three themes and subthemes were elucidated. These include the nature of PC as described by the type of patients encountered and the working and learning environment, stressors as a junior doctor due to self-perceived professional identity and frequent rotations, and tensions between culture, service needs, and staff support programs. These aspects interact in a multi-dimensional manner and can both support and predispose JDs to burnout. Conclusion: The impact of working in PC as JDs on burnout risks is complex. The relationship between culture, identity and systemic policies needs to be further investigated to provide insight on how we may foster wellbeing as a community of practice.