The work and training situation for young physicians undergoing specialty training in gynecology and obstetrics in Germany: an assessment of the status quo.

PURPOSE: General conditions in the health-care system in Germany have changed dramatically in recent years. Factors affecting this include above all demographic change, rapid developments in diagnostic and therapeutic options, and the application of economic criteria to the health-care sector. This study aimed to establish the current status quo regarding conditions of work and training for young doctors in gynecology and obstetrics, analyze stress factors, and suggest potential improvements. METHODS: Between October 2015 and March 2016, a web-based survey was carried out among residents and members of the German Society for Gynecology and Obstetrics. The electronic questionnaire comprised 65 items on seven topics. Part of the survey included the short version of a validated model of professional gratification crises for analyzing psychosocial work-related stress. RESULTS: The analysis included a total of 391 complete datasets. Considerable negative findings in relation to psychosocial work pressure, time and organizational factors, quality of specialty training, and compatibility between work and family life and work and academic tasks were detected. A high level of psychosocial work pressure is associated with more frequent job changes, reduced working hours, poorer health among physicians, and a lower subjectively assessed quality of care. CONCLUSIONS: Greater efforts are needed from all the participants involved in patient care to achieve high-quality training and working conditions that allow physicians to work in a healthy and effective way. These aspects are all prerequisites for sustainably maximizing the resource "physician" and for ensuring high-quality patient care.

Duty Rosters and Workloads of Obstetricians in Germany: Results of a Germany-wide Survey.

BACKGROUND: Compiling a daily hospital roster which complies with existing laws and tariff regulations and meets the requirements for ongoing professional training while also taking the legal regulations on the health of employees into account makes planning the duty roster a challenge. The aim of this study was to obtain a realistic picture of existing duty roster systems and of the current workloads of obstetricians in Germany. METHOD: This online survey was sent to 2770 physicians training to become obstetricians or specializing in specific areas of obstetric care. The survey consisted of an anonymized 95-item questionnaire which collected data on different types of duty roster systems and the workload of obstetricians in Germany for the period from 17.02.2015 to 16.05.2015. RESULTS: Out of a total of 2770 physicians who were contacted, 437 (16%) completed the questionnaire. Across all forms of care, the care provided outside normal working hours usually (75%) consisted of a combination of regular working times and on-call duty or even consisted entirely of standby duty. Level I perinatal centers were most likely 20% (n = 88) to have a shift system in place. Working a shift system was significantly more common in care facilities which had previously carried out a job analysis. The number of physicians in hospitals who are present during the night shift was higher in facilities with higher numbers of births and in facilities which offered higher levels of care. In addition to regularly working overtime and the fact that often not all the hours worked were recorded, it was notable that the systems used to compile duty rosters often did not comply with legal regulations or with collectively agreed working hours nor were they compatible with the staff planning requirements. OUTLOOK: The results of this study show that the conditions of work, the working times, and the organization of working times in obstetric departments are in need of improvement. Recording the actual times worked together with an analysis of the activities performed during working times and while on standby would increase the level of transparency for employers and employees.

Part-time employment of gynecologists and obstetricians: a sub-group analysis of a Germany-wide survey of residents.

BACKGROUND: Combining family and career is increasingly taken for granted in many fields. However, the medical profession in Germany has inadequately developed structures. Little is known regarding the satisfaction of physicians working part-time (PT). METHODS: This Germany-wide on-line survey collected information on the working situation of PT employees (PTE) in gynecology. An anonymous questionnaire with 95 items, nine of which concerned PT work, was sent to 2770 residents and physicians undergoing further specialist training. RESULTS: Of the 481 participants, 104 (96 % female, 4 % male) stated they worked PT, which is greater than the national average. 94 % of all women and 60 % of all men would work PT for better compatibility between work and family life. The PTE regularly work night shifts (NS) (96 %) and weekends (98 %). The number of monthly NS (median 5-9) was not different between the full-time (FT) employees and the PTE who work >75 %. Only when the working hours are reduced by 25 % or more, there are fewer NS (median 1-4) PTE that have a desire for fewer NS. The classic PT model is seldom realized; over 70 % of PTE work whole days, while other working models do not play a major role in Germany. On-call models were subjectively declared to have the best family friendly work-life balance. OUTLOOK: The results obtained indicated that structures must be developed that to address the problem of childcare and the long working hours to ensure comprehensive medical care from specialists.