are worrisome - the most poignant of which is the fact that doctors, including medical

令人擔憂的是--其中最令人痛心的是，醫生，包括醫護人員，都在為自己的健康擔憂。

students and resident physicians, have the highest suicide rate of any profession.

學生和住院醫師，是所有職業中自殺率最高的。

In this video, we'll cover burnout, a common precursor to depression and suicide, in medical

在這段視頻中，我們將從醫學角度介紹職業倦怠，這是抑鬱症和自殺的常見前兆。

trainees.

受訓者：

We'll go over what burnout is, what causes burnout, and how you can reduce your own risk

我們將介紹什麼是職業倦怠，什麼原因導致職業倦怠，以及如何降低自己的風險。

of burning out.

的燒燬。

What's going on guys, Dr. Jubbal, MedSchoolInsiders.com.

這是怎麼回事夥計們，朱波醫生，醫學流派內幕網。

Burnout can be described as a physical or mental collapse caused by overwork or stress,

職業倦怠可以說是由於過度勞累或壓力造成的身體或精神崩潰。

often relating to caregiving activities or work.

往往與護理活動或工作有關；

It is thought to be derived from three distinct elements, including emotional exhaustion,

它被認為是由情緒疲憊等三個明顯的要素衍生出來的。

depersonalization, and reduced sense of personal accomplishment.

非人格化，個人成就感降低。

Keep those three elements in mind, as we'll be referring to them throughout this video.

請記住這三個要素，因為我們將在整個視頻中提到它們。

Burnout is everyone's business. Burnout has reached epidemic levels, in some studies

職業倦怠是每個人的事。在一些研究中，職業倦怠已經達到了流行病的程度。

exceeding 50% of medical trainees or doctors in practice.

超過50%的受訓醫生或執業醫生；

It's not exclusive to just medical students and residents, but rather workers in all industries.

這不僅僅是醫學生和住院醫師的專屬，而是各行各業的工作者。

In this video, we'll be focusing on the data regarding burnout in medical trainees

在這段視頻中，我們將重點關注有關醫學生職業倦怠的數據。

and doctors.

和醫生。

This, too, is everyone's business, as burnout contributes to an increased risk of medical

這也是每個人的事情，因為職業倦怠會導致醫療風險增加。

errors, depression, and adverse effects on patient safety. You don't want your

錯誤、抑鬱和對患者安全的不良影響。您不希望您的

doctor burned out.

醫生燒壞了。

There are several theories on what causes burnout, the most convincing of which is the

關於導致職業倦怠的原因有幾種理論，其中最有說服力的是

Job Demands-Resources Model.

工作需求-資源模型。

In its simplest terms, the Jobs Demands-Resources Model states that high job demands lead to

最簡單的說法是，工作需求-資源模型指出，高工作需求會導致

exhaustion, and low resources lead to cynicism and feelings of low personal efficacy.

疲憊不堪，資源匱乏，導致玩世不恭和個人效能低下的感覺。

Overall, chronic exposure to stress is the main risk factor. It's no surprise, then,

總的來說，長期暴露在壓力之下是主要的風險因素。那麼，這也就不足為奇了。

that medical students and residents in particular are subject to extraordinarily high rates

特別是醫科學生和住院醫師的發病率非常高。

of burnout.

的倦怠。

It's common for medical trainees to be deprived of sleep, have a high workload, relatively

睡眠不足、工作量大、相對來說，醫科實習生睡眠不足是常有的事

low salaries, and several responsibilities in their workplace.

工資低，在工作中又身兼數職。

Yet there are other tremendous but often overlooked stressors in this profession, including the

然而，在這個行業中，還有其他巨大的但經常被忽視的壓力，包括

great responsibility for the health of other people, dealing with patients, their pain,

對他人的健康負有重大責任，與病人打交道，他們的痛苦。

and their families.

及其家人。

In a 2018 meta-analysis and systematic review by Rodrigues and colleagues, it was found

在2018年Rodrigues及其同事的一項薈萃分析和系統回顧中發現

that residents in surgical, like general surgery and ortho, and urgent specialties, like anesthesiology

外科（如普外科和骨科）和急診專科（如麻醉科）的住院醫師。

and OBGYN, demonstrated significantly higher rates of burnout.

和婦產科醫生，表現出明顯較高的倦怠率。

Additional factors correlated with burnout include younger age, female gender, and having a high workload.

與職業倦怠相關的其他因素包括年齡較小、女性性別和工作量大。

Interestingly, students who are single are significantly more emotionally exhausted than

有意思的是，單身的學生在情感上的疲憊程度明顯高於。

classmates in relationships.

同學關係中。

This doesn't mean to run out and get into a relationship pronto, but it does highlight

這並不意味著要馬上跑出去談戀愛，但它確實突出了。

the importance of social support in warding off burnout.

社會支持對防止倦怠的重要性；

If you look at the rates of burnout over the past few decades, there has been a consistent

如果你看一下過去幾十年的職業倦怠率，就會發現，在過去的幾十年裡，職業倦怠率一直在持續上升。

and steady rise.

並穩步上升。

After scouring the literature and trends in medical training, I would attribute this to

在蒐羅了文獻和醫學培訓的趨勢後，我會將其歸結為： 1.

three main factors:

三個主要因素：

First, increasing competitiveness.

第一，提高競爭力。

Over the past 10 years, medical school has become significantly more competitive, with

在過去的10年裡，醫學院的競爭明顯加劇，有了

a significant rise in the number of applicants, but not enough new positions in medical school

報考人數大幅增加，但醫學院的新增崗位不足。

to accommodate the increase.

以適應增長的需要。

In such a landscape, pre-med and medical students are subject to ever increasing levels of stress.

在這樣的格局下，醫學預科生和醫學生承受的壓力越來越大。

Dr. Atul Gawande wrote an excellent piece in The New Yorker about how technological

阿圖爾-加萬德博士在《紐約客》上寫了一篇很好的文章，講述了技術如何。

changes in medicine have contributed to burnout.

醫學上的變化導致了職業倦怠。

In short, increasing requirements for computer documentation are highly correlated with burnout,

總之，對計算機文檔的要求越來越高，與職業倦怠高度相關。

which is why neurosurgeons are less likely to be burned out than emergency physicians

這就是為什麼神經外科醫生比急診醫生更不容易被燒傷的原因。

– they just spend less time documenting.

- 他們只是花更少的時間記錄。

Additionally, decreasing physician autonomy is a major factor, as outlined by the Jobs

此外，醫生自主權的下降也是一個重要因素，正如《就業》所概述的那樣。

Demand-Resources Model.

需求-資源模型。

Having more equal representation by both men and women in medicine is no doubt a great thing.

在醫學界有更多的男女平等代表無疑是一件好事。

There are more female physicians now than ever before.

現在的女醫生比以往任何時候都多。

In fact, 2017 marked the first year where there were more women than men enrolled in

事實上，2017年是女性報名人數首次超過男性的一年。

medical schools.

醫學院；

It is important to note, however, that the literature has consistently demonstrated that

然而，必須指出的是，文獻一致表明：

women are more likely than men to experience burnout, and the increasing rates of women

女性比男性更有可能經歷職業倦怠，而且女性的比例越來越高。

in medicine is one of many factors contributing to increasing rates of burnout over the years.

在醫學領域，是多年來導致職業倦怠率上升的眾多因素之一。

This is obviously not a judgement in any way, but rather an objective reporting of

這顯然不是什麼判斷，而是客觀的報告。

the data.

的數據。

By understanding differences in burnout pattern causes and behaviors between men and women,

通過了解男女之間職業倦怠模式原因和行為的差異。

we become better equipped to solve a multifaceted and complex issue.

我們變得更有能力解決多方面的複雜問題。

For example, as reported by the AMA, burned out female physicians are more likely to sleep,

例如，據美國醫學會報道，倦怠的女醫生更容易入睡。

eat junk food, or binge eat than their male counterparts.

吃垃圾食品，或暴飲暴食比他們的男性同行。

The 2018 Medscape Physician Burnout & Depression Report noted that women rank family and romantic

2018年Medscape醫生職業倦怠與抑鬱報告》指出，女性將家庭和浪漫的

relationships as top factors contributing to burnout, whereas for men, finances was

人際關係是導致職業倦怠的首要因素，而對男性而言，經濟是導致職業倦怠的首要因素。

number one.

第一。

Further examination of the patterns in burnout between men and women is necessary in order

有必要進一步研究男女之間的倦怠模式，以便：

to best address and overcome this complex issue.

以最佳方式解決和克服這一複雜問題。

In order to address burnout, we must look at both preventative and therapeutic interventions.

為了解決職業倦怠問題，我們必須從預防和治療兩方面著手。

How do we reduce the risk of it happening, and if it has happened, what can we do about

我們如何降低發生這種情況的風險，如果已經發生了，我們又能做些什麼呢？

it?

它？

Similarly, we must examine how individuals can best deal with burnout, and what we need

同樣，我們必須研究個人如何才能最好地應對職業倦怠，以及我們需要什麼

to change on a systemic level to reverse the trend of increasing burnout over the last

在系統層面上進行變革，以扭轉過去幾年中日益嚴重的倦怠趨勢。

several decades.

幾十年來，。

On an individual level, there are 4 main pieces of actionable advice:

就個人而言，有4個主要的可操作建議。

First, social support.

第一，社會支持。

The most consistent finding throughout the scientific literature is that social support

整個科學文獻中最一致的發現是，社會支持

reduces burnout.

減少倦怠。

Women seem to be better at this, seeking professional help for burnout on average 31% of the time

女性在這方面似乎更勝一籌，平均有31%的時間因職業倦怠而尋求專業幫助；

compared to men at 24%.

而男性為24%。

My advice to you is two-fold: first, seek professional help if you believe you are burned

我給你的建議有兩點：第一，如果你認為自己被燒傷了，要尋求專業的幫助。

out, depressed, or suicidal.

出、抑鬱或自殺。

Second, seek the support from your friends, family, and colleagues.

第二，尋求親朋好友、同事的支持。

I advise doing a shared activity where you can speak at ease and with relative privacy,

我建議做一個共享的活動，在這裡你可以放心地說話，而且有相對的隱私。

such as during a hike, a relaxed sport, or grabbing a meal or coffee.

如在遠足、休閒運動、吃東西或喝咖啡時。

Second, sleep.

第二，睡眠。

Sleep duration is negatively correlated with burnout, meaning the more you sleep, the less

睡眠時間與職業倦怠呈負相關，即睡得越多，越不

likely you are to be burned out.

你很可能會被燒掉。

Unfortunately, if you're burned out, your sleep quality is likely to suffer.

不幸的是，如果你倦怠了，你的睡眠品質很可能會受到影響。

I have an entire playlist on sleep videos going over the best ways to optimize your

我有一個完整的睡眠視頻播放列表，去優化你的最好的方法。

sleep, with actionable advice on improving sleep hygiene and consistently waking up significantly

睡眠，並提供改善睡眠衛生的可操作建議，讓你在醒來時始終保持明顯的睡眠品質。

more refreshed.

更加神清氣爽。

Link in the description below.

鏈接在下面的描述中。

Number three, optimize your day-to-day life.

第三，優化你的日常生活。

Life optimization is the name of the game here at Med School Insiders.

生活優化是醫派內參這裡的遊戲名稱。

In creating a future generation of happier, healthier, and more effective doctors, we

在打造更快樂、更健康、更高效的未來一代醫生的過程中，我們的目標是

understand that your personal and professional lives are not siloed apart, but rather are

明白你的個人生活和職業生活不是孤立的，而是

closely intertwined.

緊密交織在一起。

Optimizing your sleep, productivity, and overall efficiency is going to go a long way.

優化你的睡眠、生產力和整體效率會有很大的進步。

However, there are frequently overlooked aspects that deserve highlight.

然而，有一些經常被忽視的方面值得強調。

First, shorten your commute.

首先，縮短你的通勤時間。

When I was in plastic surgery residency, I paid a premium to live near the hospital.

我在整形外科住院時，花錢住在醫院附近。

This reduced my commute drastically and also allowed me to cycle to and from work.

這大大減少了我的通勤時間，也讓我可以騎車上下班。

Ultimately, this meant more time for sleep, and I was able to get cardio twice daily,

最終，這意味著更多的睡眠時間，我可以每天進行兩次有氧運動。

automatically.

自動。

Other ways you can buy yourself more time include ordering takeout instead of cooking

其他可以為自己爭取更多時間的方法包括叫外賣而不是做飯。

yourself, getting a housecleaning service, or using ride-sharing services like Uber or

自己動手，找家政服務，或者使用Uber等乘車服務。

Lyft rather than driving.

Lyft而不是開車。

Maintaining healthy habits such as proper nutrition and regular exercise will also go

保持健康的生活習慣，如適當的營養和定期的運動，也將有助於提高生活品質。

a long way in sustaining this intense lifestyle and warding off burn out.

對維持這種緊張的生活方式和抵禦倦怠有很大的幫助。

And number four, an important point about vacations.

第四，關於假期的一個重要觀點。

Contrary to popular belief, they may not be as helpful as you think.

與流行的看法相反，它們可能沒有你想象的那麼有用。

The reduction in burnout symptoms is short lived, lasting on average less than 3 weeks.

職業倦怠症狀的減輕是短暫的，平均持續時間不到3周。

Plus, we want sustainable fixes, and vacations are relatively infrequent if you work in the

另外，我們要的是可持續的修復，而假期相對較少，如果你在。

medical profession.

醫學專業；

Now onto the systemic causes.

現在談談系統性原因。

Ultimately, burnout is more of a systemic issue than a personal issue. While we must

歸根結底，職業倦怠與其說是個人問題，不如說是一個系統問題。雖然我們必須

all take responsibility and mitigate it in our own lives, the fact that burnout among

在我們自己的生活中，所有的人都要承擔責任並減輕它，事實上，在我們的生活中，職業倦怠是一個很重要的問題。

medical students, residents, and attending physicians has been consistently rising for

醫學學生、住院醫師和主治醫師的人數一直在持續上升。

decades points to a systemic cause.

幾十年來，指出了一個系統性的原因。

More and more medical schools and residency programs are pushing wellness programs to

越來越多的醫學院和住院醫師項目都在推動健康計劃的開展。

address this growing issue.

解決這一日益嚴重的問題。

While these programs may have good intentions, their utility and ultimate benefit is questionable.

雖然這些計劃可能有良好的意圖，但其實用性和最終的利益是值得懷疑的。

A major point of contention is the fact that these programs push an undertone that burnout

一個主要的爭論點是，這些項目推崇的是一種倦怠的底色。

is the responsibility of the medical student or resident – a failure of individuals to

是醫學生或住院醫師的責任------個人的失誤

properly self-care, sleep, and mitigate stress.

適當的自我保健，睡眠，緩解壓力。

Rather, we need to urge our programs and institutions to make meaningful changes.

相反，我們需要敦促我們的項目和機構做出有意義的改變。

Facilitating social support, sleep, and autonomy are areas that, based on the scientific literature,

根據科學文獻，促進社會支持、睡眠和自主性是這些領域。

would be beneficial to this growing issue.

將有利於解決這一日益嚴重的問題。

Burnout has been strongly correlated with suicidal ideation, even after controlling

職業倦怠與自殺意念有很強的相關性，即使在控制了

for depression.

對於抑鬱症。

This is something I care deeply about, as I've lost friends, colleagues, and classmates

這是我非常關心的事情，因為我已經失去了朋友、同事和同學。

to suicide.

到自殺。

Nothing was being done about it, and suicides were being swept under the rug.

沒有采取任何措施，自殺事件被掩蓋起來。

So I decided to do something about it.

所以我決定做點什麼。

Together with a team of other medical students and residents passionate about this issue,

和其他熱衷於這個問題的醫學生和住院醫師團隊一起。

we have started an initiative to raise awareness and help fund proposals in reducing medical

我們已經啟動了一項倡議，以提高人們的認識，並幫助資助減少醫療費用的建議。

student and resident physician burnout, depression, and suicide.

學生和住院醫生的職業倦怠、抑鬱和自殺；

It's called the #SaveOurDoctors Grant.

這就是所謂的#拯救我們的醫生撥款。

If you too refuse to sit idle in this epidemic, this is your chance to take a stand.

如果你也拒絕對這種流行病坐視不理，這就是你表明立場的機會。

There are three ways for your to help: first, submit a video on the submission page

您可以通過三種方式提供幫助：首先，在提交頁面上提交一個視頻

outlining your own proposal and enter for a chance to win yourself.

勾勒出你自己的提案，並有機會贏得自己。

Second, blast #SaveOurDoctors on your social media accounts.

第二，在你的社交媒體賬戶上轟擊#拯救我們的醫生#。

And third, donate to the cause.

第三，捐獻事業。

Fully 100% of all proceeds go toward the grant and addressing this issue.

所有收益完全100%用於資助和解決這個問題。

I've personally put $1,000 from my own pocket into this, but if you're willing to donate

我個人自掏腰包捐了一千塊錢，但如果你願意捐的話

even $5, that too will go a long way.

哪怕是5塊錢，那也會走得很遠。

Thank you for watching.

謝謝你的觀看。

I hope this video has helped you understand burn out and provided you with actionable

希望這段視頻能幫助你理解倦怠，併為你提供可操作的。

advice.

建議。

If you too are passionate about doing something, please get involved with the #SaveOurDoctors movement

如果你也熱衷於做一些事情，請參與到#拯救我們的醫生#運動中來。

Thank you for your support.

謝謝你的支持。