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The theme of this issue of the Postgraduate Medical Journal is burnout. As Professor Bernard Cheung makes clear in his editorial1 physician burnout is not due to failings on the part of any individual. It is far more a consequence of social, cultural and technological pressures that affect the profession as a whole. Few young people applying for medical school can imagine what most medical careers nowadays are actually like: a decade or more in further studies, working hours that may be twice as long as their former school friends, possibly earning half or a quarter as much as some comparable professions, and in work settings where bureaucracy, technology and managerialism may trump vocation, professionalism or prestige. In effect, the conditions for burnout are set early on.
The doctors who manage to transcend these challenges appear mainly to be those who are imbued with a particular passion. According to Tait Shanafelt and his team of leading researchers on burnout at Stanford University, attempts to deal with the problem should therefore aim at “high professional fulfilment, rather then just burnout mitigation”2 Some doctors achieve such fulfilment as academic researchers, competent administrators, medical politicians, or leaders of institutions. An increasing number choose to divide their energies between medicine and their families, or have an absorbing outside interest like sport or the arts. At some point …
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