Barbara Buddeberg-Fischer

Formal mentoring programmes for medical students and doctors – a review of the Medline literature

Mentoring programmes have been implemented as a specific career-advancement tool in the training and further education of various groups in the medical profession. The main focus of our investigation was to examine what types of structured mentoring programmes exist for doctors as well as for medical students, what short- and long-term goals these projects pursue, and whether statements can be made on the effectiveness and efficiency of these programmes. A literature-search strategy was applied to Medline for 1966–2002 using the keyword combinations: (a) mentor* [AND] program* [AND] medical students, and (b) mentor* [AND] program* [AND] physicians. Although a total of 162 publications were identified, only 16 papers (nine for medical students and seven for doctors) met the selected methodological criteria. The majority of the programmes lack a concrete structure as well as a short- and long-term evaluation. Main goals are to increase professional competence in research and in further specialization and to build up a professional network for the mentees; no statements are to be found on the advantages for the mentors. Programme evaluation is for the most part presented descriptively in terms of great interest and high level of satisfaction. No publication contains statements on the effectiveness or the efficiency of the programme. Although the results of mentoring are promising, more formal programmes with clear setup goals and a short- and long-term evaluation of the individual successes of the participants as well as the cost-benefit analysis are needed.

Work stress and reduced health in young physicians: prospective evidence from Swiss residents

ObjectivesJob stress, investigated by the effort–reward model in various working environments in different countries, has been widely reported, yet studies addressing physicians are lacking. The present study investigated the perceived job stress, its association with the amount of working hours, and its impact on young physicians’ self-reported health and their satisfaction with life during residency.MethodsIn a prospective study design, a cohort of Swiss medical school graduates was followed up, beginning in 2001. In their second and fourth years of residency, 433 physicians assessed their effort–reward imbalance, overcommitment, physical and mental well-being and satisfaction in life. Taking the longitudinal design into account, four categories of stressed residents were defined: (1) subjects not reporting high work stress at either measurement, (2) subjects reporting high work stress in the second but not in the fourth year of residency, (3) subjects with onset of high work stress in fourth year and (4) residents reporting high work stress at both measurements.ResultsAll components of the perceived stress at work were significantly correlated with the amount of working hours, effort showing the highest correlation. While two-thirds of the participants do not report high work stress, assessed by the extrinsic part of the effort–reward imbalance model (the ratio between effort and reward) and 12% show a decrease of stress over time, there are 15% with an increase of stress over time, and 10% with persistently high stress experience. In terms of the intrinsic stress component (overcommitment), 71% show low values, 12% show a decrease, 9% an increase and 8% constantly high values. The groups with constant and increasing extrinsic and intrinsic stress experience exhibit significantly worse health and life satisfaction compared to the remaining groups, after controlling for gender and baseline health.ConclusionsStress at work in young physicians, especially when being experienced over a longer period in postgraduate training, has to be a matter of concern because of its negative impact on health and life satisfaction and the risk of developing symptoms of burnout in the long run.

Swiss residents' speciality choices--impact of gender, personality traits, career motivation and life goals.

BackgroundThe medical specialities chosen by doctors for their careers play an important part in the development of health-care services. This study aimed to investigate the influence of gender, personality traits, career motivation and life goal aspirations on the choice of medical speciality.MethodsAs part of a prospective cohort study of Swiss medical school graduates on career development, 522 fourth-year residents were asked in what speciality they wanted to qualify. They also assessed their career motivation and life goal aspirations. Data concerning personality traits such as sense of coherence, self-esteem, and gender role orientation were collected at the first assessment, four years earlier, in their final year of medical school. Data analyses were conducted by univariate and multivariate analyses of variance and covariance.ResultsIn their fourth year of residency 439 (84.1%) participants had made their speciality choice. Of these, 45 (8.6%) subjects aspired to primary care, 126 (24.1%) to internal medicine, 68 (13.0%) to surgical specialities, 31 (5.9%) to gynaecology & obstetrics (G&O), 40 (7.7%) to anaesthesiology/intensive care, 44 (8.4%) to paediatrics, 25 (4.8%) to psychiatry and 60 (11.5%) to other specialities. Female residents tended to choose G&O, paediatrics, and anaesthesiology, males more often surgical specialities; the other specialities did not show gender-relevant differences of frequency distribution. Gender had the strongest significant influence on speciality choice, followed by career motivation, personality traits, and life goals. Multivariate analyses of covariance indicated that career motivation and life goals mediated the influence of personality on career choice. Personality traits were no longer significant after controlling for career motivation and life goals as covariates. The effect of gender remained significant after controlling for personality traits, career motivation and life goals.ConclusionGender had the greatest impact on speciality and career choice, but there were also two other relevant influencing factors, namely career motivation and life goals. Senior physicians mentoring junior physicians should pay special attention to these aspects. Motivational guidance throughout medical training should not only focus on the professional career but also consider the personal life goals of those being mentored.

Career obstacles for women in medicine: an overview

This article describes the current position of women in the field of medicine.

The impact of gender and parenthood on physicians' careers - professional and personal situation seven years after graduation

BackgroundThe profile of the medical profession is changing in regard to feminization, attitudes towards the profession, and the lifestyle aspirations of young physicians. The issues addressed in this study are the careers of female and male physicians seven years after graduation and the impact of parenthood on career development.MethodsData reported originates from the fifth assessment (T5) of the prospective SwissMedCareer Study, beginning in 2001 (T1). At T5 in 2009, 579 residents (81.4% of the initial sample at T1) participated in the questionnaire survey. They were asked about occupational factors, career-related factors including specialty choice and workplace, work-life balance and life satisfaction. The impact of gender and parenthood on the continuous variables was investigated by means of multivariate and univariate analyses of variance; categorical variables were analyzed using Chi-square tests.ResultsFemale physicians, especially those with children, have lower rates of employment and show lower values in terms of career success and career support experiences than male physicians. In addition, parenthood has a negative impact on these career factors. In terms of work-life balance aspired to, female doctors are less career-oriented and are more inclined to consider part-time work or to continue their professional career following a break to bring up a family. Parenthood means less career-orientation and more part-time orientation. As regards life satisfaction, females show higher levels of satisfaction overall, especially where friends, leisure activities, and income are concerned. Compared to their male colleagues, female physicians are less advanced in their specialty qualification, are less prone to choosing prestigious surgical fields, have a mentor less often, more often work at small hospitals or in private practice, aspire less often to senior hospital or academic positions and consider part-time work more often. Any negative impact on career path and advancement is exacerbated by parenthood, especially as far as women are concerned.ConclusionThe results of the present study reflect socially-rooted gender role stereotypes. Taking into account the feminization of medicine, special attention needs to be paid to female physicians, especially those with children. At an early stage of their career, they should be advised to be more proactive in seeking mentoring and career-planning opportunities. If gender equity in terms of career chances is to be achieved, special career-support measures will have to be provided, such as mentoring programs, role models, flexitime and flexible career structures.

Associations between body weight, psychiatric disorders and body image in female adolescents.

Objectives: The study explored associations between body weight, psychiatric disorders and body image in a nonclinical sample of female adolescents. It was also investigated whether complaints of negative body image could be an indicator of psychiatric morbidity. Methods: A sample of 136 Swiss female high school students, 15–20 years of age, initially had weight, height and body image (FBeK questionnaire) assessed and were screened for psychiatric morbidity (SSQ). Subsequently, they were assessed using the DIA-X psychiatric interview which generates DSM-IV diagnoses. Univariate, multivariate, regressive and canonical correlation analyses were performed. Results: Being overweight was significantly correlated with a more negative body image (attractiveness/self-confidence). There were also significant correlations between psychiatric diagnoses and unfavorable body image (3 of the 4 FBeK scales). Besides having a more disturbed body image, overweight subjects also evidenced more psychiatric morbidity. The multiple regression analysis revealed that psychiatric disorders had the greatest association with negative body image, followed by age and weight. The canonical correlation indicated that body image, psychiatric disorder, age and weight clearly correlated with one another (Rxy = 0.43). Conclusion: Psychosomatic research should be more concerned about issues of obesity and concurrent psychiatric morbidity and aim to develop preventative as well as therapeutic treatment methods. Physicians should be aware of the associations between obesity, negative body image and psychiatric morbidity.

The impact of mentoring during postgraduate training on doctors’ career success

Medical Education 2011: 45:488–496

Epidemiology of eating behaviour and weight distribution in 14– to 19-year-old Swiss students

Buddeberg‐Fischer B, Bernet R, Sieber M, Schmid J, Buddeberg C. Epidemiology of eating behaviour and weight distribution in 14– to 19‐year‐old Swiss students.

Prevention of disturbed eating behaviour: a prospective intervention study in 14‐ to 19‐year‐old Swiss students

Subsequent to an epidemiological study on eating behaviour in adolescents, a prospective study was carried out to examine the effect of health promotion lessons on disturbed eating behaviour. From the original sample (t1, n=1944), a subgroup of 314 students of both sexes, 14–19 years of age, was selected. Participants came from a total of 20 classes in which a high percentage of students exhibited disturbed eating behaviour. Ten classes were then randomly selected to receive health promotion lessons (intervention group, high‐risk; IGHR), while the other 10 classes served as controls (control group, high‐risk; CGHR). The Eating Attitudes Test (EAT‐26), the Giessen Physical Complaint List for Children and Adolescents (GSCL‐C) and the Self‐Report Symptom Check‐List (SCL‐90‐R) were administered shortly before (t2) and 3 months after (t3) the interventions. The three health promotion lessons dealt with issues concerning beauty ideals, gender differences in psychosexual maturation and body awareness, healthy eating behaviour, physiology of nutrition, early symptoms of eating disorders and therapeutic approaches. The data analyses revealed an improvement on all three symptom scales for both groups between t2 and t3, but there were no significant differences between the IGHR and CGHR groups. When data from high‐scoring female participants only were analysed (HRf‐IGHR and HRf‐CGHR), the multivariate analysis revealed a significant interaction between time and group (15.2% of variance explained). Our experiences in implementing health promotion lessons that conveyed knowledge about eating disorders and addressed physical and psychological issues in a more general way indicated that these interventions can be carried out in schools, and may contribute to increases in physical and psychological well‐being in a high‐risk population of adolescents.

Relationship between Disturbed Eating Behavior and Other Psychosomatic Symptoms in Adolescents

BACKGROUND There has been relatively little research on subthreshold eating disorders and factors which might promote their transition to eating disorders. METHODS A sample consisting of 1,944 Swiss adolescents of both sexes, 14-19 years of age, was investigated for eating behavior (EAT-26), psychological (SCL-90-R) and physical symptoms (GSCL-C). In addition, the relationship between eating behavior and other psychosomatic symptoms was analyzed. RESULTS The results revealed significantly higher scores for females than males on all except one scale of the questionnaires. Three categories of disturbed eating behavior based on the EAT scores were described: EAT 0-9 = not disturbed (77.5% girls, 93.1% boys), EAT 10-19 = moderately disturbed (14.1% girls, 5.5% boys), and EAT > or = 20 = severely disturbed (8.3% girls, 1.5% boys). With regard to the three aspects, eating habits, psychosomatic symptoms and suicidality a significant correlation between disturbed eating behavior and concurrent psychological and physical symptoms was found in female but not in male subjects. CONCLUSIONS The results emphasized that disordered eating behavior has to be seen as part of a broader psychopathological syndrome, especially in young women.