November 01, 2018, 03:50 pm Michael Devitt – Family medicine residency coordinators wear many hats. Not only are they responsible for meeting the administrative needs of program directors and faculty members, they also frequently serve as human sounding boards, providing much-needed emotional and social support for residents.
Skillfully executing the duties and responsibilities of a residency coordinator may be rewarding, but the role also can become the perfect breeding ground for burnout. Frequent changes in residency program requirements and still-evolving restrictions in resident duty hours have only served to make the coordinator's job more challenging.
And although the AAFP and other organizations have made physician well-being a priority in recent years, virtually no attention has been paid to residency coordinators, according to the authors of a new report published in the October issue of Family Medicine.
The report details job satisfaction levels and burnout prevalence among 307 family medicine residency coordinators across the United States and shows that, although coordinators generally are satisfied with the work they do, they -- like the other professional members of the residency team -- also are subject to burnout and often feel worn out and overwhelmed by their work.
Residency coordinators completed a 39-item survey consisting of demographic questions (e.g., gender, number of years on the job, location of the residency program) along with modified questions from the Professional Quality of Life: Compassion Satisfaction and Fatigue Version 5 survey, a tool used to measure the positive and negative affects of people whose work is to help others by specifically asking about issues related to job satisfaction and burnout.
Of the residency coordinators who responded during the April 2017 to July 2017 survey period, an overwhelming majority -- 96.6 percent -- were female. Slightly more than half of respondents, 51 percent, reported being in their current job for five years or less. Most residency coordinators (62.6 percent) worked in community-based programs that were affiliated with or administered by a medical school; another 23.8 percent worked in community-based programs that were not affiliated with such an academic institution. Most programs (64.5 percent) were located in urban or suburban settings.
Overall, 28.4 percent of the coordinators reported high job satisfaction, whereas 25.5 percent reported low satisfaction with their current position. Most coordinators (94.1 percent) said they often or very often took satisfaction from being able to help people, 83.6 percent reported often or very often being proud of what they could do to help, and 82.1 stated that they often or very often liked their work as a coordinator.
Satisfaction rates were somewhat lower in other areas, however. Less than 68 percent of the coordinators reported that their work often or very often made them feel satisfied, and only 59.6 percent said they often or very often were pleased with their ability to keep up with work responsibilities.
Burnout rates were distributed in a similar pattern, with 23.6 percent of respondents reporting high levels of burnout and 25.9 percent reporting low burnout levels.
When asked about factors that contribute to burnout, 35 percent of coordinators reported they often or very often felt "worn out" because of their work, 48 percent reported they often or very often felt "bogged down by the system," and 48.7 percent said they often or very often felt overwhelmed because of a seemingly "endless" workload.
Links between job satisfaction and burnout existed in several areas. Analysis of the survey responses suggested that more satisfied coordinators had lower burnout rates, with burnout level and number of years in service considered significant predictors of a coordinator's job satisfaction level.
To increase satisfaction and decrease burnout, the authors recommended that coordinators should be included in ongoing efforts to promote awareness of the importance of resident well-being. Because many coordinators reported concerns about the amount of work they are required to perform, the authors also suggested taking steps to ensure that a coordinator's workload is manageable and to recognize and provide positive reinforcement for jobs well done. And because coordinators only answered the survey once, the authors suggested conducting a longitudinal study to see how burnout and satisfaction rates evolve over time.
AAFP News asked Samuel Ofei-Dodoo, Ph.D., M.P.A., research educator and assistant professor in the Department of Family and Community Medicine at the University of Kansas (KU) School of Medicine-Wichita and the study's lead author, and Rick Kellerman, M.D., professor and chair of KU's Department of Family and Community Medicine and a study co-author, to expand on the suggestions they made in their research report.
One easy but often overlooked way to reduce residency coordinators' stress, both authors noted, is to personally acknowledge the work that they do.
"Given the significant logistical, social and emotional support that family medicine residency coordinators provide to residents, fellows, faculty and staff, their work should be recognized. A simple 'thank you' card could help," Ofei-Dodoo said.
"We learned from the coordinators that a simple 'thank you' and acknowledgement from administration goes a long way," Kellerman agreed.
Other tactics to support residency coordinators may take more effort. For example, Ofei-Dodoo observed that coordinators often have to enter the same information into multiple databases, which could contribute to job dissatisfaction and burnout. "To deal with the issue of multiple reporting, we suggest a single reporting system where FMR coordinators could enter all program/resident information into one database," he said. Ofei-Dodoo suggested that such a database could be accessed by several agencies, such as the AAFP, American Board of Family Medicine and Accreditation Council for Graduate Medical Education (ACGME) as needed, saving coordinators time and cutting down on duplicative work.
With regard to workload, Kellerman recalled that when he completed his residency at Wesley Medical Center in Wichita in 1981, the program had one coordinator who "took care of everything." According to Kellerman, "The same residency with the same number of residents now has three coordinators," which shows how the amount of work for coordinators has increased since that time.
Both Ofei-Dodoo and Kellerman emphasized the importance of administrative support to balance the workload for everyone involved. "Attention to workload is important," Kellerman said. "Are there enough coordinators to do the job? Are job responsibilities appropriate?"
Ofei-Dodoo agreed that ensuring residency programs have enough support staff to complete their work is a key step in improving job satisfaction and reducing burnout in the long run, and he also suggested that the ACGME clarify language on residency coordinator roles and responsibilities in its program requirements.