Combined Empowerment, Continuous Appraisal, Psychological and Career Counseling Improve Medical Cadets’ Satisfaction and May Offset Burnout During Internship Year. An 18-Months Successful Experience in a Tertiary Medical Center

Background. Following graduation from school of medicine, Israeli medical cadets complete a 12-months training period in hospitals. This year, their jump-start of career, has profound influence on their future contribution to our national workforce. The crisis in the healthcare system is already notable in this group of physicians, with burnout, sense of personal and professional uncertainty and disorientation resulting from the nature of their changing environment. Methods. In the largest Israeli tertiary hospital, we established an education authority, overseeing cadets as trainees rather workers. We offer them constructed, personalized psychological and counselling services with continuous process of appraisal. During an 18-month period we followed their monthly feedback relating to their satisfaction, learning experience and level of socialization with their peers and superiors. The study was designed as comparative research assessing cadets’ satisfaction measurements before, and after intervention as a surrogate marker for their burnout. Results. Comparison of measured parameters amongst our study population (before and after intervention) showed statistically significant improvement, with interns stationed in the surgical departments (n = 86) showing the highest degree of improved satisfaction: the extent of acquiring new knowledge and competencies [Likert questionnaire results (1 to 5 LQR) went from 2.2 ± 1.0 to 3.3 ± 1.42 ; p < 0.005]; experience from the absorption process into the department [LQR from 2.6 ± 1.2 to 3.5 ± 1.56 ; p < 0.05], degree of motivation to recommend peers to apply for residency [LQR from 2.3 ± 1.0 to 3.1 ± 1.6 ; p = 0.05] and the experience of being accepted to the department by the staff nurses [LQR from 2.7 ± 1.3 to 3.5 ± 1.1 ; p < 0.05]. Conclusions. A combined, ongoing process of appraisal, empowerment, psychological and career counseling seems promising in the relenting effort to improve cadets’ satisfaction and hopefully withhold the burnout process of young physicians.