Factors influencing job satisfaction in the European health workforce: a Junior Doctors’ perspective

Factors influencing job satisfaction in the European health workforce: a Junior Doctors’ perspective

Authors: Patrick Pihelgas, Alvaro Cerame, David Alves Berhanu, Miglė Trumpickaitė, Konstantinos Roditis

Context
Since the 1960’s there has been an oscillating growth in the number of healthcare workers in the European Union. Despite the growth in numbers, Europe is experiencing problems in medical workforce planning, including long-term shortage of professionals, insufficient recruitment in some specialties, medical desertification, and recently rising struggles with workforce retention. There is a strong correlation between job dissatisfaction and intention to quit. The lack of satisfaction is mostly affected by burnout syndrome to which junior doctors are especially susceptible. We aimed to study work-related experiences of junior doctors to identify possible factors that influence attrition.


Methods 
The European Junior Doctors’ Association conducted a study between January and June 2023 with the aim of exploring European junior doctors’ work-related experiences and the impact of those experiences on their personal and professional lives. The focus was set on identifying similarities in different member countries of the organization, and to collect proposals for increasing their job satisfaction and contribute to the retention of junior doctors.
The study was based on semi structured qualitative interviews with representatives from 24 national medical associations, who were purposely sampled to achieve parity or overrepresentation of the female gender. Gathered data was then analyzed thematically to follow topics that were explored in the interviews: job satisfaction, wellbeing, job resignations, working experiences, quality of training, personal lives, gender inequalities, proposals, and specific issues. An informed consent process was carried out with all participants.

Results
Three cross-cutting elements were identified that affect junior doctors’ job dissatisfaction across  all 24 European countries: work-related experiences, training-related experiences and difficulties in work-life balance.

  • Work-Related Experiences
    •  Work Overload: Excessive workload leading to physical and mental exhaustion.
    • Poor Working Environment: Stressful atmosphere, lack of recognition, and vulnerability to mistreatment.
    • Compensation Concerns: Inadequate remuneration for workload and responsibilities.
    • Lack of Flexibility: Hindrance to academic tasks, educational activities, and reconciling work with caregiving responsibilities.
    • Mobility and Employment Concerns: Frequent relocations and temporary employment causing dissatisfaction.
  •  Training-Related Experiences:
    • Overwhelming Workloads: Detrimental to the quality of postgraduate training.
    • Insufficient Supervision and Feedback: Lack of guidance impacting skill development.
    • Limited Time for Academic Activities: Constraining academic progression.
    • Inadequate Clinical Skills Development: Feeling of insufficient progress in training.
  • Work-Life Balance:
    • Inflexible Schedules: Interfering with personal life, particularly caregiving responsibilities.
    • Career Impact: Decisions affecting work-life balance influencing career advancement.

Discussion
Over 30% of doctors in Europe are over the age of 60 and expected to retire in the next five years, highlighting the importance of ensuring the generational replacement of doctors. Growing demands for better work-life balance across European societies may be extending to the medical workforce. Instead of focusing on workforce recruitment, which has so far been the main strategy, more emphasis needs to be put on retention of the current workforce. This in turn demands changes in the existing system. Often the discussion around working conditions revolves around salaries, but as the results of our study show, salary is but one and certainly not the highest ranking factor influencing healthcare workforce retention. Collaborative action needs to be taken on both the national and the medical establishments level, without forgoing the need for personal accountability regarding the creation of suitable working conditions, workload and work environment.

Associated links: 
European Health Management Association Official Website

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