Method: Semi-structured interviews and focus groups were held with 47 registrars, supervisors, medical educators and program training advisors. Questions considered their understanding of burnout in GP registrars, causal factors and possible intervention strategies. Interviews and focus groups were audio recorded, transcribed and thematically analysed.
Results: Descriptions of burnout fell under seven domains, primarily related to disengagement and impaired performance. Stakeholders noted that detection of burnout can be masked by non-specific symptoms such as flat affect and relational withdrawal. Key causes included resource deficiencies (e.g. low confidence, unsupportive practice culture), a high load of professional and personal demands, and aspects related to the medical culture itself (e.g. perfectionism, self-sacrifice). Subgroups of trainees experienced extra stressors (e.g. exams, the adjustment from the hospital setting to general practice). Recommended strategies considered individual resources (e.g. setting boundaries), the practice environment (e.g. registrar-supervisor relationship), training organisation requirements (e.g. empowering trainees), and changes to the broader medical system and culture (e.g. challenging stigma).
Discussion: Our findings help to contextualise existing models of well-being and burnout. Whilst these findings have specific application to Australian GP registrar training they are also broadly applicable to the Australian GP context more generally.
Implications for practice: The experience of GP registrar well-being and burnout is highly complex, and individualised. In addition to the need for registrar self-care, practices and training organisations also need to implement strategies to support registrars well-being.