Medical interns at the breaking point: workload in Peru's healthcare systems
DOI:
https://doi.org/10.53732/rccsalud/e8820Keywords:
internado médico, carga de trabajo, estrés ocupacionalAbstract
Introduction. Medical internships in Peru expose students to demanding work schedules that may affect their physical and mental well-being. Objective: To determine the perceived workload among medical interns in institutions of the Ministry of Health (MINSA) and Social Health Insurance (EsSalud), exploring workplace factors, academic demands, and perceived psychosocial risks. Materials and Methods. An observational, cross-sectional, and analytical study was conducted, with prospective data collection through surveys administered to medical interns during 2024. A questionnaire including sociodemographic, occupational, and academic variables was used, along with the NASA Task Load Index (NASA-TLX), which assesses perceived workload. A total of 75 valid surveys were analyzed. Results. Statistically significant differences were found in three NASA-TLX dimensions between MINSA and EsSalud interns: mental demand (8.49 vs. 7.81), physical demand (8.07 vs. 7.44), and frustration (7.37 vs. 6.47), all higher among MINSA interns (p < 0.05). High perceived workload was more frequent among MINSA interns (OR = 4.58) and males (OR = 3.52). Conclusion. The institutional environment influences perceived workload among medical interns, being higher in MINSA facilities than in EsSalud. Likewise, males showed a higher risk of high workload compared to females. These findings highlight the importance of context and a gender-based perspective in medical internships.
References
1. Ministerio de Salud del Perú. Directiva Administrativa N.º 313-MINSA/DIGEP-2022. Directiva que regula el desarrollo del internado en ciencias de la salud en los establecimientos de salud del Ministerio de Salud y Gobiernos Regionales. Lima: MINSA; 2022.
2. Asociación Peruana de Facultades de Medicina (ASPEFAM). Internado Médico en el Primer Nivel de Atención. Currículo y Manual de Interno. 1.ª ed. digital. Lima: ASPEFAM; 2021. https://www.aspefam.org.pe/series.htm
3. Parr JM, Pinto N, Hanson M, Meehan A, Moore PT. Medical graduates, tertiary hospitals, and burnout: A longitudinal cohort study. Ochsner J. 2016;16(1):22–6. https://www.ncbi.nlm.nih.gov/pubmed/27046399
4. Hannan E, Breslin N, Doherty E, McGreal M, Moneley D, Offiah G. Burnout and stress amongst interns in Irish hospitals: contributing factors and potential solutions. Ir J Med Sci. 2018;187(2):301–7. http://dx.doi.org/10.1007/s11845-017-1688-7
5. St Onge JE, Allespach H, Diaz Y, Poitier A, Tamariz L, Paidas C, et al. Burnout: exploring the differences between U.S. and international medical graduates. BMC Med Educ. 2022;22(1):69. http://dx.doi.org/10.1186/s12909-022-03135-x
6. Lall MD, Gaeta TJ, Chung AS, Dehon E, Malcolm W, Ross A, et al. Assessment of physician well-being, part One: Burnout and other negative states. West J Emerg Med. 2019;20(2):278–90. http://dx.doi.org/10.5811/westjem.2019.1.39665
7. Castro Méndez N, Suárez Cretton X. Riesgos psicosociales y su relación con la salud laboral en un hospital. Cienc Psicol. 2022;16(1):1–12. https://doi.org/10.22235/cp.v16i1.2551
8. Palma A, Gerber MM, Ansoleaga E. Riesgos psicosociales laborales, características organizacionales y salud mental: el rol mediador de la violencia laboral. Psykhe. 2022;31(1):e22383. https://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0718-22282022000100104
9. Hart SG, Staveland LE. Development of NASA-TLX (Task Load Index): Results of empirical and theoretical research. Advances in psychology. 1988;52: 139-183. https://doi.org/10.1016/S0166-4115(08)62386-9
10. Acosta Prieto JL, Cuello Cuello Y, García Dihigo J, Almeda Barrios Y. Modelos para la valoración de la carga mental de trabajo: una revisión sistemática. RSAN. 2023;1(55):158-80. https://doi.org/10.36097/rsan.v1i55.2272
11. Díaz-Ramiro EM, Rubio-Valdehita S, Martín-García J, Luceño-Moreno L. Estudio psicométrico del Índice de Carga Mental NASA-TLX con una muestra de trabajadores españoles. Rev Psicol Trab Organ. 2010;26(3):191-9. http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1576-59622010000300003&lng=es
12. Van Vendeloo SN, Prins DJ, Verheyen CCPM, Prins JT, van den Heijkant F, van der Heijden FMMA, et al. The learning environment and resident burnout: a national study. Perspect Med Educ. 2018;7(2):120–5. http://dx.doi.org/10.1007/s40037-018-0405-1
13. Kgatle M, George J, Dominic F, De Jager P. Prevalence and factors associated with burnout among junior medical doctors at a South African tertiary public sector hospital. Pan Afr Med J. 2024;47:208. https://doi.org/10.11604/pamj.2024.47.208.41865
14. Mendoza-Ochoa FE, Silva-Caicedo RF. Revisión sistemática de la literatura: factores que inciden en el síndrome de burnout en el personal de salud. MQRInvestigar. 2025;9(1):e347. https://doi.org/10.56048/MQR20225.9.1.2025.e347
15. Lin Y-H, Chen H-Y, Tsai S-L, Chang L-R, Chen P-C. A prospective study of the factors associated with life quality during medical internship. PLoS One. 2019;14(8):e0220608. http://dx.doi.org/10.1371/journal.pone.0220608
16. Lam TP, Wong JGWS, Ip MSM, Lam KF, Pang SL. Psychological well-being of interns in Hong Kong: What causes them stress and what helps them. Medical Teacher. 2010;32(3):e120-6. https://doi.org/10.3109/01421590903449894
17. Lyubarova R, Salman L, Rittenberg E. Gender Differences in Physician Burnout: Driving Factors and Potential Solutions. Perm J. 2023;27(2):130-136. https://doi.org/10.7812/TPP/23.023
18. Fiorilli C, Barni D, Russo C, Marchetti V, Angelini G, Romano L. Students’ Burnout at University: The Role of Gender and Worker Status. Int. J. Environ. Res. Public Health 2022;19(18):11341. https://doi.org/10.3390/ijerph191811341
19. Miranda-Ackerman RC, Barbosa-Camacho FJ, Sander-Möller MJ, et al. Burnout syndrome prevalence during internship in public and private hospitals: a survey study in Mexico. Med Educ Online. 2019;24(1):1593785. https://doi.org/10.1080/10872981.2019.1593785
20. Feingold JH, Kaplan CA, Hart A, Waldman R, Kronman H, Brody J, et al. We Get by with a Little Help From Our PEERS: The Practice Enhancement, Engagement, Resilience, and Support Program for Building Community and Well-Being in Medical Education. Acad Med. 2022;97(6):858-862. https://doi.org/10.1097/ACM.0000000000004669
21. Abrams MP, Salzman J, Espina Rey A, Daly K. Impact of Providing Peer Support on Medical Students' Empathy, Self-Efficacy, and Mental Health Stigma. Int J Environ Res Public Health. 2022;19(9):5135. https://doi.org/10.3390/ijerph19095135
22. Wothe J, Bosacker L, Nalluri H, Cullen MJ, Brunsvold ME. Improving Mental Health Support, Career Transitions and Access to Health Care for Surgical Residents. J Surg Educ. 2022;79(2):286-289. https://doi.org/10.1016/j.jsurg.2021.09.014
23. Major A, Williams JG, McGuire WC, Floyd E, Chacko K. Removing Barriers: A Confidential Opt-Out Mental Health Pilot Program for Internal Medicine Interns. Acad Med. 2021;96(5):686-689. https://doi.org/10.1097/ACM.0000000000003965
24. Ginzberg SP, Gasior JA, Passman JE, Flemming DJ, Thiels CA, Farley DR, et al. Surgeon and Surgical Trainee Experiences After Adverse Patient Events. JAMA Netw Open. 2024;7(6):e2414329. https://doi.org/10.1001/jamanetworkopen.2024.14329
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