The challenge of Burnout in Public Medical Teachers in Pakistan: A mixed methods study

Background and Objectives: Burnout is common in healthcare workers and affects multiple domains of functioning. The objective of this study was to assess burnout in medical teachers in a large public medical university in Lahore, Pakistan and explore the factors behind it. Methods: Using an explanatory sequential mixed methods design, we first sent out the abbreviated Maslach Burnout Inventory (aMBI) to all teaching faculty of basic and clinical science at King Edward Medical University (KEMU) Lahore. Descriptive analysis was performed on the 203 respondents who returned the survey. Of those who scored higher on the aMBI, 10 respondents (8 clinical science faculty and two basic science faculty) were selected for detailed semi-structured interviews exploring possible reasons for burnout. Thematic analysis of interview transcripts was performed using Interpretive Phenomenological Analysis. Triangulation and member checking was used for validation. Results: About 38.9% of respondents scored high on the Emotional Exhaustion subscale and 31.5% scored high on the Depersonalization subscale. There were statistically significant differences on the mean Emotional Exhaustion scores (p <0.001) between Basic and Clinical Sciences Departments with respondents from the Clinical Departments having higher scores (7.84 +/- 4.32). Four main themes and multiple subthemes emerged around burnout after qualitative analysis of the data. These included 1. Work-related factors 2. Family and social factors including challenges related specifically to women 3. Feelings and emotions and 4. Personal Qualities. Conclusion: A significant proportion of medical faculty experiences burnout related to their professional and personal responsibilities. The reasons are varied. Policy planners and University/College administrators must acknowledge the negative effects of burnout on medical teachers and take steps to ameliorate it in the interests of improving medical education and training.