1. Work-life balance What does this mean to medical students at different stages of training, and are they achieving it? Aled Picton Education Fellow ASME Best Practice in Undergraduate Medical Education Conference 5 April 2017

2. Outline What is already known on this topic? Who cares? What was done?
What does this add?
Questions and discussion

3. What is already known on this topic?
Stress, depression and burnout3,4
Challenges of postgraduate training5
Work-life balance
Career decisions6
Lack of consensus on overall concept
Self-care1,2
References:
General Medical Council Your health matters: Practical tips and sources of support.
General Medical Council Good Medical Practice.
Clay AS, Ross E, Chudgar SM, O’Connor Grochowski C, Tulsky JA, Shapiro D. The emotions of graduating medical students about prior patient care experiences. Patient Education and Counselling. 2015; 98:
Ludwig AB, Burton W, Weingarten J, Milan F, Myers DC, Kligler B. Depression and stress amongst undergraduate medical students. BMC Medical Education. 2015; 15:141.
Goodyear HM. First year doctors’ experience of work-related wellbeing and implications for educational provision. International Journal of Medical Education. 2014; 5:
Diderichsen S, Andersson J, Johansson EE, Verdonk P, Lagro-Janssen A, Hamberg K. Swedish medical students’ expectations of their future life. International Journal of Medical Education. 2011; 2:

4. Research questions
What does the term ‘work-life balance’ mean to medical students?
How do medical students perceive their own work-life balance?
Do medical students receive support with their work-life balance?

5. Who cares?

6. What was done?
Mixed methods study of Years 3-5 Birmingham medical students in March-April
Questionnaire survey- 145 responders, response rate 84%
Open-ended definition question
Individual interviews with 44 students
Current and expected work-life balance
Expectations for Foundation Years

7. Meeting work requirements
What does work-life balance mean to you?
Enjoyment
Work-life balance
Meeting work requirements
Time management

8. Contributing factors: Contributing factors: Contributing factors:
Social life
Hobbies
Relaxation
Fulfilment of personal needs16
Interview data
Enjoyment
‘There is no good end point in medicine. There is always something more you could be doing’
Year 3 student
Work-life balance
Meeting work requirements
Time management
Contributing factors:
Professional culture3
Peer groups
Exams
On-call commitments
Patient care stressors
Contributing factors:
Study skills
Own priorities, which may change over time11
Ability to create and navigate borders23

9. Contributing factors:
The bigger picture
Work-life balance
Time management
Enjoyment
Meeting work requirements
Contributing factors:
Social life
Hobbies
Relaxation
Fulfilment of personal needs
Professional culture
Peer groups
Exams
On-call commitments
Patient care stressors
Study skills
Own priorities, which may change over time
Ability to create and navigate borders
Impact
Health
Wellbeing
Stress
Burnout
Support:
Family
Friends
University
‘There is no escaping it. Your mindset is always thinking about work. You go home and it’s still there. You don’t get to eat, don’t get to sleep.’
Year 4 student

10. ‘I wish I had known from the outset I could have a work-life balance’
Year 5 student

11. Personal mentor training

12. Junior doctors’ contracts
What does this add?
Strengths New research questions Open-ended approach Mixed methods High response rates
Limitations
Institution
Only Years 3-5
Timing
Junior doctors’ contracts

13. Thanks for listening. Any questions? aled.picton@nhs.net