Brandeis Magazine

Winter 2023/2024

Physician, Heal Thyself

Burnout, low morale, and a lack of collegiality plague academic medicine. But there is a cure.

An illustration of a physician wearing blue scrubs, holding their head in their hands.

Photo Credit: Getty Images

By Lawrence Goodman

In 2023, Linda Pololi and her research colleagues published a paper in the Journal of Clinical and Translational Science based on a survey of roughly 150 midcareer research faculty at 58 U.S. medical schools.

The survey results were startling. About 40% of respondents reported experiencing high burnout, and 41% said they had low “vitality,” a measure of how enthusiastic and motivated they felt about their work. Over half reported receiving poor mentoring, and almost a third reported poor relationships with colleagues.

These findings are consistent with studies by other researchers showing low morale among academic researchers. Moreover, the problem seems to have worsened over the past decade: In a 2010 article from the University of Pittsburgh, 16% of early-career clinical investigators surveyed reported burnout.

Pololi, a Distinguished Research Scientist in Heller’s Institute for Economic and Racial Equity, has studied academic medicine’s organizational culture for more than 20 years. In 2006, she founded the National Initiative on Gender, Culture, and Leadership in Medicine — called C-Change, for short — at Brandeis to bring awareness to issues and help drive culture change in academic medicine.

Academic medical faculty often hold a master’s or a PhD in addition to a medical degree, and divide their time between caring for patients and performing research, thereby laying the groundwork for major medical breakthroughs. Pololi says the high burnout rate they report threatens to slow the pace of research and harm the quality of American medical care.

“Nobody would propose that people are their most productive, most compassionate, and most creative if they feel burnt out,” she says.

Academic doctors also train medical students. According to Pololi, research shows students begin their medical education feeling altruistic and idealistic, yet graduate feeling cynical. Teaching faculty’s disillusionment with their profession may be one reason why.

“The behavior and attitudes modeled by the faculty can be picked up on by their students,” she says.

Pololi and her collaborators’ work has consistently shown that women, who make up about 41% of full-time faculty in academic medicine, suffer from lower morale than men. In the 2023 study, women were more likely than men to experience burnout and consider leaving academic medicine altogether. Prior C-Change research has clearly shown that sexism is rife in medical schools.

Doctors in general have long complained about their profession, citing problems related to corporatization and bureaucracy. But academic medicine is different from private practice. Its  practitioners are usually salaried staff of medical schools and hospitals. They typically make less money than non-academic doctors. At the same time, they are free from the financial pressure to see lots of patients, and the need to market their services and wrangle with health-care companies to secure reimbursement.

The COVID-19 pandemic led to widespread burnout among front-line healthcare providers. But medical researchers found it a more meaningful time to be in their profession, according to another study led by Pololi, which was published in 2021 in JAMA Network Open.

“These are extremely difficult times but also very exciting, because the coronavirus has defined better than ever the meaning of my work,” one academic researcher told Pololi, a theme repeated by many.

For Pololi, the temporary shift in attitudes during the pandemic suggests academic medical researchers’ burnout and low morale stem largely from their failure to find meaning in their day-to-day work. The root of the problem lies in the highly competitive and isolating culture of academic medicine. Researchers vie with one another for grants. The pressure to publish is enormous. A sense of community and institutional support is sometimes lacking.

Worse, many medical researchers suffer from “moral distress,” she says, because their values don’t align with their institution’s ethics.

“It’s intellectually and emotionally very challenging work,” Pololi says. “You spend a lot of time with people who are suffering, or do research with the aim to help them. But the systems and institutions we have in place don’t really support the humanity of the faculty.”

For the past seven years, C-Change has offered mentorship and career guidance to medical researchers across the U.S. C-Change replaces the traditional one-on-one mentorship model with facilitated group peer-mentoring. It’s a novel career-development model “characterized by nonhierarchical peer relationships, empowerment, self-direction, and reflection,” says Pololi.

Discussions focus on forming lasting professional bonds and relationships, identifying one’s core values, and aligning career objectives with one’s values. The work also focuses on appreciating diversity, mindfulness, listening, and leadership skills.

In August, Pololi and several colleagues published findings from a five-year National Institutes of Health-funded study of the C-Change mentorship model, involving 40 midcareer research faculty from 16 states. Compared to a control group who didn’t participate in the program, they reported increased vitality; said they valued diversity more; and stated they now had higher cognitive empathy, stronger antisexism and antiracism skills, and higher self-efficacy in mentoring others.

Perhaps most important, they reported higher self-confidence in their ability to advance in their careers and succeed in their research.

“Our system, carefully worked out over a decade, has now been rigorously and scientifically tested, and shows what needs to be done,” Pololi says.