Background and objectives: Based on the Effort-Reward-Imbalance Model by Siegrist a study was undertaken to find out (a) in what way young doctors assess effort and reward during their specialist training; (b) whether there are certain job stress patterns over time; and (c) what the correlations are, if any, between perceived job stress, health and satisfaction with life.
Methods: Within the framework of a prospective study (2001 - 2007) 370 doctors who had just qualified and were residents in the German-speaking part of Switzerland were assessed four times by means of anonymized questionnaires. Job stress, measured by the Effort-Reward-Imbalance scale, as well as health and satisfaction with life were assessed in these doctors' 2nd (T2), 4th (T3), and 6th (T4) year of specialist training ("residents"). Stress patterns of the participants were evaluated, based on the effort and reward scale values at T2, T3, and T4, by two-step cluster analysis. Gender differences between the clusters were calculated by the 2 test and differences in the continuous variables by analysis of variance with repeated measurements.
Results: During residency the percentage of doctors who experienced an Effort-Reward-Imbalance (ratio between effort and reward ERI > 1) increased from 18% at T2 to 20 % at T3 to 25 % at T4. The cluster analysis revealed two clusters: Type 1 (67%) with effort values below average and reward values above average (ER balance) across the three measurement points, and type 2 (33 %) with effort values above average and reward values below average (ER imbalance). Subjects in cluster 2 showed unfavorable values, when compared with those in cluster 1, in overcommitment, in workload and in the health variables (anxiety, depression, physical and psychological well-being), as well as in their assessed satisfaction with life at all three measurement points.
Conclusions: One third of the doctors experienced stress at work, caused by an effort-reward imbalance. This had a negative impact on their health and satisfaction with life. Regular supervision and goal-oriented career counselling provided by senior physicians could contribute to young doctors not feeling so much stressed at work, feeling well and being more content with their work.