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Student Editorials

Making happy doctors

BMJ 2005; 330 doi: (Published 01 March 2005) Cite this as: BMJ 2005;330:050391
  1. Ed Peile, associate dean1,
  2. Yvonne Carter, dean1
  1. 1Warwick Medical School, University of Warwick, Coventry CV4 7AL

Medical students must receive regular, structured, and constructive appraisal to detect unhappiness and promote effective change, argue Ed Peile and Yvonne Carter

Unhappy doctors often underperform,1 and by depressing morale in the workplace, they exert a negative influence on recruitment and retention, which are pressing problems in the NHS.2 Everything we can do to promote contentedness at work is therefore a worthwhile endeavour in the interest of patients.

Much of the difference in the ways that doctors approach work and perceive the climate at the workplace is a reflection of stable long term individual differences in the doctors themselves.3 In a comprehensive questionnaire study, which included measures of approaches to work, workplace climate, stress (general health questionnaire), burnout (Maslach burnout inventory), and satisfaction with medicine as a career as well as the Big Five personality inventories, McManus et al obtained data on 1668 medical graduates, 12 years after they had entered medical school. They were able to relate doctors' present perceptions of the workplace climate to differences in measures of personality and learning style, which were already evident at medical school entry, and remained fairly stable when measured again in the final year at medical school and five years later in working doctors. Stress, burnout, and satisfaction also correlate with trait measures of personality taken five years earlier. Neuroticism for example, is a stable trait. It is unrelated to learning styles, but it is a predictor of a surface disordered approach to work, of a perceived high workload in the preregistration house officer year, and of stress. Traits such as extravertness, being open to experience, and agreeableness seem to confer advantages at work.3

We should not allow a cop-out for workplace environments where systemic conditions result in high levels of reported stress among doctors. But we …

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