The medical programmes we see in our training as physician-scientists are becoming more progressive and supportive of students. Here’s what academia can learn from them, say Yoo Jung Kim and Erik Faber.
Many researchers experience burnout at some point in their career.Credit: chabybucko/Getty
Burnout — work-related stress resulting in emotional and physical exhaustion — remains an expected rite of passage for many professions. However, the medical community has begun to place more emphasis on reducing burnout — and science academia would do well to learn from it.
Despite the differences between medical and scientific training, stress is a common denominator for students in both fields. For example, in a 2011 survey of graduate students at 26 major US universities, 37% of graduate students in the natural sciences and 41% in engineering or computer science reported experiencing “a bit more” or “a lot more” stress than they felt able to handle. Similarly, a 2010 cross-sectional study found that 52.8% of medical students at 7 US universities had experienced burnout1.
Graduate students must contend with juggling coursework and research, lack of external validation, perceived devaluation of their work by the public and anxiety over future job prospects. All of these stressors combine to create a toxic environment in which cynicism and pessimism can prevail. Many studies have shown that people who experience stress also experience decreased productivity2 and creativity3, compared with those who feel little or no stress — yet these two traits are key to being a successful scientist.
Graduate programmes can help students to combat burnout. We propose that institutions take the following steps:
1. Enable time away from the lab. In sectors such as the technology industry, flexible work policies have led to more-satisfied, more productive employees4,5. Although working from home or taking time off spontaneously is less feasible in medical and graduate training, some institutions have embraced trainee wellness, allowing students to take absences as needed.
At Stanford University School of Medicine in California, medical students who are rotating in the clinic or the hospital can take up to two or three days of absence during every four- to- eight-week rotation, including for their well-being. This allows students to take care of themselves discreetly by attending health-services appointments and arranging counselling and psychological services as needed, without having to disclose what care they’re seeking.
2. Create external incentives and validation. Although many graduate students are self-driven, a reward system could help students to feel more valued by their research community. Some medical-residency training programmes have employed external reward systems to increase research productivity: for instance, at one residency programme at the University of Missouri in Columbia, trainees are awarded points for every major step they take in research-oriented endeavours, such as publishing a paper or presenting at conferences6. The points are then converted into extra funding for career-related enrichment, such as personal medical equipment, books, travel to academic events and membership of professional organizations.
To celebrate student accomplishments, PhD programmes could implement a similar reward system for progress made on a research project, or introduce a ‘grad student of the month’ award or incentives such as gift cards or funds.
3. Connect graduate students with the public.According to a 2017 survey conducted jointly by news organization HuffPost and global data company YouGov, only 35% of US adults trust that “what scientists say is accurate and reliable”. Early in their training, medical students must learn how to communicate complex medical concepts to patients from all backgrounds. To help science trainees connect with the public and hone their communication skills, programmes should encourage students to engage and educate the lay audience. The Stanford neuroscience department, for example, organizes ‘Brain Day’ events, in which graduate students give hands-on demonstrations to students and adult learners using real human and animal brains. Outreach activities such as these can help graduate students to feel valued, and teach them how to communicate their work.
4. Expose students to non-academic job opportunities. According to the 2017 Survey of Doctorate Recipients conducted by the US National Science Foundation, the unemployment rate for doctoral scientists and engineers across all fields as of February 2017 was 2.1%, and the unemployment rate for those with a science doctorate in a field of biology was 2.4% — both better than the US national unemployment rate at the time of 4.7%.
The perceived dearth of jobs could stem from an implicit belief in academia that tenure is the holy grail. This idea is perpetuated by the structure of academic science training: tenured or tenure-track professors are the gatekeepers who mentor, validate and fund graduate students and their work. These individuals are the science professionals whom graduate students often look up to most.
By contrast, although many medical students and residents are trained in academic hospitals, they are exposed to many different potential career paths through rotations, informal mentoring and professional conferences, including in academia, private practice, administration and policy. Rather than promoting a uniform view of success, graduate programmes should elevate the many career options available outside academia early in their training, and encourage exploration in industry, government, communications, policy and education.
5. Facilitate research into graduate-student wellness. “There remains a dire need to resolve our understanding of the mental health issues in the trainee population,” reads a study of graduate-student well-being7. For many years, the medical community has been conducting research on student, resident and physician wellness, not only for the sake of the profession, but also because the well-being of health-care providers can affect patient health and safety.
Science might not have a comparable impetus for studying the wellness of its own students, but academia as a whole needs to collect and publish these data to optimize graduate training, reduce the emotional and psychological burden on trainees and help students to understand that they are not alone.
Both medicine and academic science have a long way to go in terms of addressing trainee health, but academia can start by building on existing groundwork. A culture that promotes well-being and prevents burnout is necessary for producing the next generation of scientists — scientists who are not only happy, but also maximally creative and productive.
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