Mental Health and Burnout, Part 1

The DEI Shift's mission is to create a podcast series on diversity, equity, and inclusion (D.E.I.) in medicine that sparks discussion and provides practice-changing data and stories for a physician, student, allied health professional, and health care leader audience. Listeners will be able to gain useful information to improve their practices and environments, to gain empathy, cultural competency, and humility, and to learn more about emerging D.E.I. concepts. The DEI Shift will discuss issues related to gender, race, sexuality, religion, ability, socioeconomics, and so much more.

Co-Hosts: Dr. DJ Gaines, Branden Barger

Guest: Dr. Allison Ibarra

Editor/Assistant Producer: Clara Baek

Production Assistants: Nilgoun Farhadi, Leyna Nguyen

Learning Objectives:

1. Define burnout according to the World Health Organization.
2. Learn and be able to recognize common signs of burnout.
3. Identify and recognize the potential consequences burnout can have on physicians’ and medical trainees’ physical and mental well-being.

[00:00-1:03] Welcome and Introduction of the co-hosts

• Introducing co-hosts, Dr. DJ Gaines and fourth-year medical student, Braden Barger

[1:03-3:43] Defining Burnout

• The World Health Organization (WHO) defines burnout as “a syndrome conceptualized as resulting from chronic workplace stress that has not been managed”.
• According to the ACP module, common characteristics of burnout are
  • Feelings of energy depletion or emotional exhaustion
  • Depersonalization, cynicism, or negativism related to one’s job, or increased mental distance from one’s job
  • Feelings of diminished personal efficacy or accomplishment in the context of the work environment
• Burnout is associated with increased rates of depression, suicide, substance use, medical errors and physician turnover.

[3:43-5:00] Introducing Dr. Allison Ibarra

• Dr. Allison Ibarra is finishing her third year of internal medicine residency, and will soon begin her time as chief resident at UC San Diego (UCSD). (Conflict of Interest Disclosures: None.)
• She hopes to specialize in Gastroenterology.

[5:00-9:01] Dr. Ibarra’s experience with burnout in medical school and residency

• Dr. Ibarra reflects on her medical school journey, especially how she enjoyed her third year of school.
• Her first experience in burnout was while studying for the Step 1 exam that followed her third year of medical school, which was a catalyst for her to begin therapy. 
• During her intern year at UCSD, she was under immense stress from her work and from her experiences of coming out.
• After realizing she was experiencing burnout and depression, she resumed therapy and started taking medications.

[9:01-12:00] Working through burnout

• Although she did recuperate from most feelings of burnout with therapy and medications, she is still learning how to fully overcome burnout, and questions if that is even possible.
• Talking openly to people about hardship has been one of the most helpful ways Dr. Ibarra was able to work through burnout.

[12:00-18:57] Dr. Ibarra’s support systems through her medical journey

• In medical school, her support system was her friends and classmates.
• Because she began residency during the COVID-19 pandemic, she was not able to build friendships with her co-interns, causing a generalized burnout across her residency year.
• She also is supported by her family and her little sister, who she lived with throughout her intern year.
• She got a puppy during the pandemic, which has been an immense support structure.
• She felt that the nature of medical school allowed for built-in resources that had provided her community, mentors, and general support.
• She feels that there are opportunities to create even more built-in support structures in residency programs across the nation
• Dr. Ibarra is currently creating a “LGTBQIA+ in GME” (graduate medical education) community

[18:57-23:21] Advice or resources Dr. Ibarra recommends for those pursuing mental health care

• Know that you are able to discontinue anything that you start
• Seek out resources at your local institution, many programs have implemented some form of mental health programming into their institution.
• She also knows of apps* such as Ginger, Calm, Headspace (Dr. Ibarra’s Conflict of Interest Disclosures: Nones)

[23:21-24:39] Take home points

• Be kind to yourself, know you are important, and are worth time and investment.
• You are not alone; there are people who are sharing your experiences and people who want to help you.
• Resources and support are available.

[24:39-25:28] Outro

If you or someone you know is experiencing suicidal thoughts or a crisis, please reach out immediately to the Suicide Prevention Lifeline at 800-273-8255 or text HOME to the Crisis Text Line at 741741. These services are free, confidential, and available 24 hours a day, 7 days a week in the US.

Credits:

Guest: Dr. Allison Ibarra

Co-Hosts: Dr. Dirk Gaines, Branden Barger

Executive Producer: Dr. Tammy Lin

Co-Executive Producers: Dr. Pooja Jaeel, Dr. Maggie Kozman

Senior Producer: Dr. Dirk Gaines

Production Assistants: Nilgoun Farhadi

Website/Art Design: Ann Truong

Music: Chris Dingman https://www.chrisdingman.com

References and Resources:

1. https://www.who.int/news/item/28-05-2019-burn-out-an-occupational-phenomenon-international-classification-of-diseases
2. (ACP 2008) Burnout and SI among US Medical Students
3. Dyrbye, Liselotte N. MD, et al. Burnout Among U.S. Medical Students, Residents, and Early Career Physicians Relative to the General U.S. Population. Academic Medicine 89(3):p 443-451, March 2014. | DOI: 10.1097/ACM.0000000000000134
4. ACP Modules and Resources
   1. Resident Well-Being Learning Hub
   2. Resources for Physician Well-Being and Professional Fulfillment
5. Consequence of medical student and resident burnout
6. Consequence of attending physician burnout
7. Article on Medical Student Burnout
8. AMA Resources on Physician Burnout and Well-being

Disclaimer: The DEI Shift podcast and its guests provide general information and entertainment, but not medical advice. Before making any changes to your medical treatment or execution of your treatment plan, please consult with your doctor or personal medical team. Reference to any specific product or entity does not constitute an endorsement or recommendation by The DEI Shift. The views expressed by guests are their own, and their appearance on the podcast does not imply an endorsement of them or any entity they represent. Views and opinions expressed by The DEI Shift team are those of each individual, and do not necessarily reflect the views or opinions of The DEI Shift team and its guests, employers, sponsors, or organizations we are affiliated with.

*Unless specifically stated otherwise, The DEI Shift does not endorse, approve, recommend, or certify any information, product, process, service, or organization presented or mentioned in this Podcast, and information from this Podcast should not be referenced in any way to imply such approval or endorsement. The DEI Shift assumes no responsibility or liability for the accuracy or completeness of the content contained in third party materials or on third party sites referenced in this Podcast or the compliance with applicable laws of such materials and/or links referenced herein.

The DEI Shift podcast is proudly sponsored by the American College of Physicians Southern California Region III Chapter. 

The DEI Shift theme music is by Chris Dingman. Learn more at www.chrisdingman.com.

Contributors

Pooja Jaeel, MD, ACP Member –  Co-Executive Producer

Allison Ibarra, MD, ACP Member - Guest

Dirk Gaines, MD, ACP Member– Co-Host

Branden Barger, MD – Co-Host

Maggie Kozman, MD, ACP Member – Co-Executive Producer

Tammy Lin, MD, MPH, FACP – Executive Producer

Nilgoun Farhadi, ACP Student Member – Production Assistant

Leyna Nguyen – Production Assistant

Clara Baek – Editor/ Assistant Producer

Reviewers

Tammy Lin, MD, MPH, FACP – Stock: Abbott Labs, Cybele Microbiome

Tiffany Leung, MD, MPH, FACP: Other – PlushCare, Inc

None of the contributors or reviewers for this educational activity have relevant financial relationship(s) to disclose with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.  All financial relationships have been mitigated.

Release Date:  February 23, 2024

Expiration Date: February 22, 2027

Accreditation Statements

CME Credit

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the American College of Physicians and the DEI Shift.  The American College of Physicians is accredited by the ACCME to provide continuing medical education for physicians.

The American College of Physicians designates each enduring material (podcast) for 0.5 AMA PRA Category 1 Credit™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

ABIM Maintenance of Certification (MOC) Points

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to .5 medical knowledge MOC Point in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program.  Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

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After listening to the podcast, complete a brief survey and multiple-choice question quiz.  To claim CME credit and MOC points you must achieve a minimum passing score of 66%.  You may take the quiz multiple times to achieve a passing score.