Systematic Review of Work-life Balance among Early Career Doctors

Abstract

Background: Early Career Doctors (ECDs) are medical doctors who are in their internship, postgraduate specialist training and medical/dental officers below the rank of principal medical/dental officers. The long hours of work, staff-shortage and various expectations at this formative stage expose ECDs to potential negative outcomes including poor work-life balance. Methods: This systematic review included all available original articles on the work-life balance among ECDs world-wide between 2006 and 2020. PubMED, Google Scholar and African Journals Online (AJOL) databases were searched, and the review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: The literature search yielded 145 articles, and after screening 33 articles were included in this review. Twenty (87.9%) of the studies were cross sectional studies, 5 (15.2%) were prospective cohort studies and 1 (3%) was an interventional study, sample size ranged from 21 to 4,581 ECDs with a mean age range 24-35±7yrs. Positive work-life balance was reported among ECDs in 4.7% Karachi, 21% Ireland, 23% USA, 27% Australia; major determining factors include work-load and burn-out, female gender, specialty and location of practice, flexibility of work schedule; and the impacts are burn-out and reduced career satisfaction. Interpretation: Work-life balance among ECDs is poor worldwide, and is worse amongst the more junior cadre and female gender. It is recommended that reduction in work hours, improved wages, social and organizational support could improve the quality of work-life balance among ECDs.