Stress, burnout and doctors' attitudes to work are determined by personality and learning style: a twelve year longitudinal study of UK medical graduates

Abstract

Background: The study investigated the extent to which approaches to work, workplace climate, stress, burnout and satisfaction with medicine as a career in doctors aged about thirty are predicted by measures of learning style and personality measured five to twelve years earlier when the doctors were applicants to medical school or were medical students.

Methods: Prospective study of a large cohort of doctors. The participants were first studied when they applied to any of five UK medical schools in 1990. Postal questionnaires were sent to all doctors with a traceable address on the current or a previous Medical Register. The current questionnaire included measures of Approaches to Work, Workplace Climate, stress (General Health Questionnaire), burnout (Maslach Burnout Inventory), and satisfaction with medicine as a career and personality (Big Five). Previous questionnaires had included measures of learning style (Study Process Questionnaire) and personality.

Results: Doctors' approaches to work were predicted by study habits and learning styles, both at application to medical school and in the final year. How doctors perceive their workplace climate and workload is predicted both by approaches to work and by measures of stress, burnout and satisfaction with medicine. These characteristics are partially predicted by trait measures of personality taken five years earlier. Stress, burnout and satisfaction also correlate with trait measures of personality taken five years earlier.

Conclusions: Differences in approach to work and perceived workplace climate seem mainly to reflect stable, long-term individual differences in doctors themselves, reflected in measures of personality and learning style.

Figure 1

Diagram showing the timing of the various stages of the survey. Note that not all applicants entered in October 1991 (despite in most cases having applied to do so), and subsequent stages of the study therefore took place at different times. Some entrants also took a year longer because of taking an intercalated degree (represented by the diagonal arrow from entrants in Oct 1991 to Final year in 1997), and a few other students delayed for other reasons. All doctors were surveyed at the end of their PRHO year, whenever that had occurred. The cohort was finally brought back into step as a single cohort with the 2002 follow-up when all doctors were studied at the same time, irrespective of the time at which they qualified. Questionnaires were given out at all the boxes shown (with the exception of a questionnaire to Entrants, who are shown merely to make the flow clearer). It should also be noted that there was a follow-up of a subset of the students in their third academic year, which is not shown here because the data are not discussed in this study.

Figure 2

Path diagram showing the relationships among the measures of personality, learning style, stress, approaches to work, and workplace climate. The width of arrows is proportional to the strength of an effect, which is shown alongside each line as a path (beta) coefficient. Negative effects are shown as red, dashed lines. For details of the statistical method and a fuller model incorporating all links, see Supplementary Information.