Relationships between overwork, burnout and suicidal ideation among resident physicians in hospitals in Japan with medical residency programmes: a nationwide questionnaire-based survey

Abstract

ObjectivesThis study examined the relationships between overwork, burnout and suicidal ideation among resident physicians working in hospitals throughout Japan.DesignA nationwide, questionnaire-based survey.SettingParticipating hospitals (n=416) were accredited by the Japanese Medical Specialty Board to offer medical residency programmes in 19 core specialties. Surveys were conducted in October 2020.ParticipantsValid responses were obtained from 4306 physicians (response rate: 49%).Outcome measuresItems pertaining to the Japanese Burnout Scale, depressive tendencies and suicidal ideation were included in questionnaires. Multiple regression analyses were performed: suicidal ideation was the response variable; sex, age, core specialty, marital status, income, weekly working hours and workplace (ownership, number of beds, number of full-time physicians and regional classification) were explanatory variables.ResultsRegarding the Japanese Burnout Scale, the highest score was recorded for ‘sense of personal accomplishment’, followed by ‘emotional exhaustion’ and ‘depersonalization’. Increased emotional exhaustion and depersonalisation were associated with longer working hours, but there was no such trend for sense of personal accomplishment. Depressive tendencies and suicidal ideation were noted in 24.1% and 5.6% of respondents, respectively. These percentages tended to increase when respondents worked longer hours. Several factors were significantly associated with suicidal ideation: female sex (reference: male, OR: 2.08, 95% CI: 1.56 to 2.77), ≥12 million yen income (reference: <2 million yen, OR: 0.21, 95% CI: 0.05 to 0.79), ≥100 working hours/week (reference:<40 hours/week, OR: 3.64, 95% CI: 1.88 to 7.04) and 600–799 hospital beds (reference: <200 beds, OR: 0.23, 95% CI: 0.07 to 0.82).ConclusionsMany Japanese residents demonstrated a tendency to experience burnout and suicidal ideation. Female sex, low income, long working hours and insufficient hospital beds were associated with suicidal ideation. To ensure physicians’ health and patients’ safety, it is necessary to advance workstyle reform for physicians.