Academic Burnout Syndrome in Medicine Students Is it really a problem?

When I was contemplating to study medicine, I referred hard and emotion to my vocational guidance teacher, he explained to me about the career and his vicissitudes, in everything we talked, he said something that he would constantly remember later, he mentioned: “In any Occasion you have had the opportunity to speak with medical students or health areas?, Apparently, no: talk to them and ask you about stress ... ". I listened to these words when I was studying the eleventh grade of secondary education, at that time it was not important, but over the years and the course of the medical career, reflect on that questioning, since I permanently saw this situation in Me and in my colleagues, this led me to ask myself some questions: Is stress actually a problem? Is it "normal" that medical students suffer stress?, What to do to mitigate it?

Content

• Is stress actually a problem?
• Is it "normal" that medical students suffer stress?
• Academic Burnout Syndrome
• What to do to mitigate it?
  • References

Is stress actually a problem?

The RAE (Royal Spanish Academy) defines stress such as "Tension caused by overwhelming situations that cause psychosomatic reactions or sometimes serious psychological disorders", Authors such as Zuluega (2018), consider that stress is complex and should be divided into eustres and distress, being the first part of the physiological and adaptive reaction to adverse conditions inherent to life and the second caused by continuity in the time of the time of the first.

If we take into account this, we comment that the Eustress is not a problem, but rather a physical and mental measure that allows us continuous eustroes or this does not cease, a situation that takes it closer and closer to the distress, a condition that is clearly a problem (1).

Is it "normal" that medical students suffer stress?

The pressure to which the students are subjected, such as: the exam to be done, the work that is soon to be delivered, the multiple readings to be developed, among many other situations, generates Eustress, The problem underlies when it extends over time, bringing with him multiple problems and disorders from the perspective of mental health, associated with deterioration of physical conditions (2).

Academic Burnout Syndrome

When distress is generated, this opens the door for the deterioration of mental and physical health, generating one of the main problems in this university population: Academic Burnout Syndrome (SBA), which is defined as a prolonged and insidious stress state, that is to say distress, caused by the deterioration of individual, organizational and social factors, affecting the performance, academic performance (3).

In the educational and sociocultural field, the health difficulties

(Physics, mental and social) And its consequences, that the deterioration of this can bring, for example: the academic lag (loss of subjects, semesters) or school dropout (abandonment of studies), which is generated during the course of the medical career, on all in the first semesters; The despair observed in students to face academic challenges, which sometimes for some students, exceed their mental and physical strength (4)

From the epidemiological perspective, the existence of the SBA is considered a problem; Through a meta-analysis published in JAMA magazine, I analyze 122.356 students from 43 countries, found that “depression is present in 27.2% of medical students in the world, and that suicidal ideation prevails in 11.1%” (5), a longitudinal study conducted in the Union American, with the participation of seven medical schools, evaluated a population of 4287 students, evidencing a prevalence of 49.6% of SBA, where 11.2% of the participants are 2 to 3 times more likely to present Suicidal ideation, With a period of maintenance of 12 -month symptoms in a 5.8% compared to those who did not present it (3).

Investigations carried out in countries such as Chile, Mexico, Peru and Venezuela have shown that moderate stress in medical students can reach values ​​greater than 67% (6), another study contemplated the participation of 583 students from third to sixth year carried out in the Peru, mentioned that 2 out of 10 students presented SBA and that in comparison this study is compatible with similar studies conducted in Chile, Colombia and Brazil (7), in Colombia according to Caballero, in its doctoral thesis of 2012, it mentions that 78.9% of students show SBA, in a sampling of 205 students (8).

What worries all this most, is that this 20% of students tend to have a bad coping of the symptoms associated with the SBA and therefore increase the risk of suicide suicide and behavior, Consequently to high levels of stress, depression, exhaustion and implications related to depersonalization and derealization disorders, which in turn lead to a deep emotional exhaustion (7), all this clearly affects the development of the life project chosen by students.

If this problem is not discovered and treated in time, it could lead to academic lag and academic dropout, apart from the problems mentioned from the perspective of mental health, according to a World Bank report, “Colombia is the second country in Latin America with greater university dropout rate; In the country, the coverage of higher education is around 52% of young people between 17 and 24 years, it is estimated that 42% of those entering educational schools end up deserting in the first years ”, being the greatest defections in the first and second semester (9).

If we delve into the factors associated with the generation of the SBA, we find organizational, social and individual factors.

Regarding The organizational factors, They are described as all the particularities related to the environment provided by the University: rigorous tasks, high load, academic demand, very demanding teachers, poor time distribution; Inadequate infrastructure: salons, library, way of reaching the institution, and all aspects corresponding to physical resources, and variables such as lack of university economic support, poor human heat and administrative cutting problems.

Social factors, part of the actors involved in training; pairs and figures of authority in situations such as: deterioration of the teaching-study relationship, poor companionship with difficulties in feedback, constant competence, conflicts, low solidarity, lack of recreational and cultural spaces or no participation in them and other unrelated factors With those of the University, such as interpersonal factors, which are associated with the category of family and friendships.

Talking about individual factors, These are related to variables such as sex, trends towards anxiety or depression, emotional instability, aptitude deficit, difficulties in study techniques, time organization and lack of communication skills: social and social Cognitive (8).

It is important to mention that the support of the university community, their academic peers, family and all the actors involved in the training process, must promote student well -being and therefore monitor that these situations do not present (10), but How to know if the SBA is presented?, There are several tests to know if the student is studying with this condition, one of the most used is the Maslach Burnout Inventory Student Survey (MBI-SS) published in 2002, which evaluates the deterioration through three spheres, which is They describe like this: emotional exhaustion; which manifests itself with negative feelings for the demands of the study, cynicism: that it is related to the “attitudes of disinterest, autosabotic, in the face of academic activities and doubts about the value of the study” and academic self -efficacy or also called low professional efficacy, being this: "The feeling of incompetence as students", which underlies the multiple doubts about the student's ability to carry out their academic work (8).

What to do to mitigate it?

If we are clear about the problem and its consequences, therefore we must mention how it can mitigate. It is important to highlight that efforts to follow up on this problem should not only be done individually, the aforementioned factors must also be taken into account.

For the Great Colombian Polytechnic, the strategies they use to mitigate the SBA in their students are based on: "Learn no", Commenting that when you have enough activities and you do not have the time to develop them, it is best not to add more activities and improve time management. "The dream" It is extremely relevant, a repairing break should be generated, at least 7 hours a day. "Be moderate", In relation to activities, it proposes to analyze those activities that are no longer enjoying themselves, talk about them and seek help to improve the perspective in which they are raised and how to address them. "Find space for everything", This refers to the organization of time, giving space to curricular and extracurricular activities, social life and all those things that are usually enjoyed, without forgetting to leave space for individual activities (11). These strategies and others more related to the areas where the problem is detected have been mentioned by Garcia (12) and Arribas (13).

It is valuable to mention that all these strategies not only prevent SBA, they are also related to the stimulation of the Academic engagement which is the counterpart or antithesis of the SBA, which is understood as the force that motivates students to provide an additional voluntary effort at a psychological, physical and emotional level in their daily work, than It leads to better results and in turn decreases the risk associated with SBA, Strengthening protective factors, seeking the strengthening of spaces that generate satisfaction, fun, inspiration, enthusiasm and that in general they raise students pleasant sensations, increasing commitment to academic work, that is, the increase in engagement levels, It provides the greatest satisfaction and emotional well -being in its university training process (14).

References

1. Gallego y, Gil S, Sepúlveda M. Theoretical review of eustress and distress defined as a reaction to psychosocial risk factors and their relationship with coping strategies. October 31, 2018 [cited December 24, 2021]; Available at: https: // repository.CES.Edu.CO/HANDLE/10946/4229
2. Escuderos A, Suárez and, Palacio J. Academic Burnout and symptoms related to mental health problems at Colombian university students | Psychology. Psychol. 2017; 45-55.
3. Dyrbye Ln, Thomas Mr, Massie FS, Power DV, Ecker A, Harper W, et al. Burnout and Suicidal Ideation Among U.S. Medical Students. ANN INTER MED. September 2, 2008; 149 (5): 334-41.
4. Loayza J, Correa L, Cabello C, Huamán M, Cedillo L, Vela- Ruiz J, et al. Burnout Syndrome in University Students: Current Stage [Internet]. Researchgate. [Cited September 8, 2020]. Available at: https: // www.Researchgate.NET/PUBLICATION/318074340_Sindrome_de_burnout_en_estudiante_universitarios_tendencias_actuales
5. Elsevier. Depression and suicide in medical students: an up -to -vocal? [Internet]. Elsevier Connect. [Cited September 9, 2020]. Available at: https: // www.Elsevier.com/ES-ES/Connect/Actuality-Sanitary/Depression-Y-Suicide-En-Studers-Medicina
6. Collazo Car, Rodríguez Fo, Rodríguez Yh. Academic stress in Latin American students of the Medicine career. : 8.
7. Vilchez-Cornejo J, Huamán-Gutiérrez R, Arce-Villalobos L, Morán-Mariños C, Mihashiro-Maguiña K, Melo-Mallma N, et al. Burnout syndrome in medical students: frequency, characteristics and associated factors. Peru Medical Act. March 10, 2017; 33 (4): 282.
8. Knight CC. The Academic Burnout: Prevalence and associated factors in university students of the Health Area of ​​the City of Barranquilla [Internet]. [Barranquila]: Universidad del Norte; 2012. Available at: http: // mangrove.Uninorte.Edu.CO/BITSTREAM/HANDLE/10584/7411/SYNDROME.PDF?sequence = 1 & isallowed = y
9. University Santo Tomas. Student permanence: an institutional timely, for the co-construction of possible scenarios [Internet]. 2015 [cited September 9, 2020]. Available at: https: // udcfd.Usta.Edu.CO/images/III_ENCUENTO_ACADEMICO/CHALLENGES/CHALLENGE1-5.PDF
10. Leon g. Can burnout affect university students? Rev Electronics Calid in Educ Su Super. May 7, 2013; 4: 130-47.
11. Peña or. What is academic burnout and how to avoid it? | POLICEP [INTERNET]. POLILECO. 2020 [cited December 24, 2021]. Available at: https: // www.cop.Edu.CO/Blog/Polivel/Burnout-Academico
12. Garcia J. Academic Burnout, Risk and Protection Factors: Influence in academic commitment and strategies used by high school and university students. 2021 [cited December 24, 2021]; Available at: https: // uvadoc.grape.es/handle/10324/49492
13. Arribas m. The academic burnout. Their relationship with burnout and various prevention strategies. 2020 [cited December 24, 2021]; Available at: https: // uvadoc.grape.es/Handle/10324/42327
14. Knight CC, Hedeich C, Garcia A. RELATIONSHIP BETWEEN BURNOUT AND ACADEMIC ENGINEMENT WITH SOCIODEMOGRAPHIC VARIABICS AND ACADEMIC. Psicol from the Caribbean. May 1, 2015; 32 (2): 254-67.