Studies suggest that burnout among medical doctors has reached epidemic proportions around the world, accompanied by alarmingly high levels of clinical depression, suicidal thoughts, job dissatisfaction and unhappiness with work–life balance 1 . The data are so compelling that some health organizations and physician groups are exploring ways to tackle these problems 2 . Almost nothing is known, however, about stress, burnout and morale among biomedical scientists. To take a closer look, we interviewed the chairs of the science departments at MD Anderson Cancer Center in Houston, Texas, between July 2011 and February 2012. We asked them to assess changes in faculty morale, to identify major sources of stress and to discuss their feelings of optimism or pessimism about the future. We found that many faculty members are struggling in the face of funding pressures, bureaucracy, administrative burdens and faculty–administration conflict. Without realizing it, we had captured the mood of an institution about to experience a difficult period that accentuated such pressures. A few months after we collected our results, MD Anderson leadership came under fire, and the centre's faculty senate conducted a separate survey to assess faculty concerns (see go.nature.com/jcmgv2 ). The survey results themselves, which suggested high clinical workload, dismay over the departure of valued leaders and displeasure with top leadership over charges of nepotism and conflicts of interest, further upset faculty members. In addition to conducting our own survey, we have talked to people at other institutions, and examined relevant publications 3 , 4 . As a result, we conclude that the discontent at MD Anderson is emblematic of distressingly low morale at centres around the country. The effects of this year's federal budget sequester have only added to the gloom (see Nature 498 , 527 – 528 ; 2013 ). Ours is a pilot effort that we hope will be the basis for wider exploration and study into burnout among biomedical scientists — already, we have had preliminary discussions about a multi-centre study. “Financial and other pressures have intensified and exacerbated each another, making research environments stressful.” Financial and other pressures are certainly not unprecedented at academic institutions. But in recent years, our findings suggest, they have intensified and exacerbated each other, making research environments particularly stressful. A measure of morale In our survey, we approached 21 department chairs. We interviewed 19; three focused on conditions unique to their own departments, but the remaining 16 shared their observations, opinions and feelings about morale in general. The responses reflect pressing issues at one institution, but suggest struggles throughout the biomedical-research community. Most of the chairs said that the morale of faculty scientists has worsened in recent years. Seven said that it had worsened significantly. As one interviewee put it, “Many faculty are deflated, unsettled and depressed. There is a sense of hopelessness; they've given up. There is some resentfulness; they've spent a long time establishing their careers and now there doesn't seem to be a way to continue doing what they like to do.” Another alluded to the uncertain future of young investigators: “When I was a postdoc, the sense was that if you're good, you'll find a job. I can't say that any more.” The main stressors seem similar across different departments. Not surprisingly, funding was a big one. Several of the chairs described academic scientists as caught in a “perfect storm”: at a time when funding rates at the US National Institutes of Health have dropped drastically, some institutions are requiring faculty members to raise higher percentages of their salaries through grants. Productive scientists at middle and even senior levels are struggling to keep their careers afloat. “These are solid scientists, not marginal scientists. I don't remember it ever being like that in the past. This hurts morale,” said one respondent. The department chairs felt that institutions see ever-increasing productivity as a major goal. Executive leaders expect faculty members to seek and obtain more grant funding continuously, achieve higher-quality publications (as measured by metrics such as journal impact factors) and generally meet higher standards for academic excellence in areas such as teaching and collaboration. Although these are admirable goals, respondents noted that constantly raising the bar for high-functioning faculty members intensifies levels of comparison and implicit competition. There is also the pressure to be continually innovative in terms of research proposals, findings, publications and, in some cases, commercialization potential. Several respondents expressed concern that this relentless pressure might cause stress and burnout, and one said that department heads worry about extreme responses such as suicide or research misconduct aimed at gaming the system. Some chairs discussed a downward spiral in which a scientist loses funding, and as a result has to reduce lab space and personnel, which in turn makes it more difficult to obtain funding. This dooms the scientist's chances as an independent investigator. Even when a career is salvaged, the researcher often suffers ongoing emotional strain as a result of losing valuable time and resources, and experiences guilt and shame about the adverse impact on the lives and careers of lab personnel. Administrative duties are another stressor. Ten interviewees complained that reports, paperwork, personnel evaluations, grant procedures, training requirements, business meetings and daily e-mail minutiae have become much more cumbersome than in the past, distracting scientists from research and sapping energy, creativity and productivity. “There are more administrative and reporting demands, to the point where they seem repetitive, overlapping and always on a high-demand time schedule,” said one respondent. Another said that they “spend much more time jumping through hoops”. A new approach This all paints a rather bleak picture. But we think that MD Anderson has made inroads towards addressing the problem as an institution, even in light of recent challenges. Twelve years ago, in response to the suicide of a colleague, a group of concerned faculty members and executive leaders formed a Faculty Health Committee (with E.R.G. as the founding chair) to develop a crisis-response protocol and to consider other ways to preserve and promote faculty welfare. The committee developed the Faculty Health Well-Being programme, of which W.H. is the director. Many of the programme's activities, such as lectures and departmental seminars, are educational. Others are designed to enhance peer support as a buffer against stress and burnout. Several are outside the realm of academic medicine: social gatherings, dance lessons, parenting support groups, opera performances, a faculty art show, meditation, yoga and t'ai chi. We launched a Faculty Assistance Program to enhance access to mental health care. We also facilitated panel discussions on work–life balance, dialogues with executive leaders and a three-day working conference on faculty health and well-being, the result of which was a book, Faculty Health in Academic Medicine: Physicians, Scientists, and the Pressures of Success 5 . Our survey results show that we still have work to do, but we have a framework in place to address problems and offer faculty support. Our faculty senate collects input from MD Anderson scientists and maintains communication with institutional leaders through multiple channels, raising morale-related issues and proposing solutions. In the case of concerns and controversies about the centre's financial decision-making, clinical operations and conflict-of-interest policies in the past few years, the faculty senate organized meetings with executive leaders to improve communication, trust, transparency and shared decision-making. At such meetings, leaders learned about the sources of faculty stress, and helped to brainstorm ways to mitigate them. We have implemented initiatives to reduce paperwork through a task force and an information-technology overhaul. And we have bolstered institutional mechanisms to provide extra financial support through bridge funding, seed funding and departmental-chair funds. Through exchanges with leaders, faculty members have learned about the financial and regulatory realities of an institution. Progress has sometimes been slow — and we cannot remove every obstacle. But the more dialogue we have and the more effectively we collaborate, the better faculty members will understand challenges, appreciate efforts, engage in the process of negotiating change and finding compromises, and stay hopeful about future progress. Could other institutions implement similar strategies? Yes, with sustained support from leaders. It sometimes takes a dramatic event, such as a financial or organizational crisis, to overcome institutional inertia and to bring executive and faculty leaders together to address their common interests. It also helps to have data. The MD Anderson faculty senate's morale survey has documented the need for the Faculty Health Well-Being programme, and has provided our leadership with incentives and directions for cultural change. These efforts are just a start, but we think a good one. It is crucial that we try to make a difference — now more than ever. References References • Author information • Related links Shanafelt, T. D. et al . Arch. Intern. Med. 172 , 1377 – 1385 ( 2012 ). PubMed Article Show context Kuerer, H. M. Holleman, W. L. Ann. Surg. 255 , 634 – 636 ( 2012 ). PubMed Article Show context National Research Council Research Universities and the Future of America(National Academies Press, 2012 ). Show context Ginsberg, B. The Fall of the Faculty(Oxford Univ. Press, 2011 ). Show context Cole, T. R. , Goodrich, T. J. Gritz, E. R. (eds) Faculty Health in Academic Medicine(Humana, 2009 ). Show context Download references Author information References • Author information • Related links Affiliations Warren Holleman is professor and Ellen R. Gritz is chair of the department of behavioural science at the University of Texas MD Anderson Cancer Center in Houston. Related links References • Author information • Related links • Related links in NPG Lab life: Balancing act Oncology burnout Stress survey A healthy work–life balance can enhance research Naturejobs blog: Working from home Naturejobs blog: Should postdocs have to work long hours? Related external links University of Texas MD Anderson Cancer Center Report: Research Universities and the Future of America
转眼到美国已经四个月了，真没想到被“美国鬼子”同化这么难！语言的交流障碍依旧是一个难题，看来语言的功夫非一朝一夕也！Roman is not bulit in one day! 昨天收到同事的来信，着实让我激动半天，原来是单位的同事大都miSS我了！想想过去，虽然时时地批评他们，时时怨恨他们，时时纠正他们的缺点，可他们居然不适应我不在的日子。这多么让人欣慰！ 事实上，准备出国的时候，极不顺心，可以说是悲情逃窜，想想自己近二十年辛苦的工作经历：那么忘我，那么投入，那么公心为上，最后居然被一伙小人暗算，我只好愤然辞去职务......... 不知道回国的路如何走?不知道明天会如何？但我坚信一点，是金子总会发光！莫愁前路无知己，天下谁人不识君....... 在临行前的两周里，众人热情的相送尽管平静不了我内心的凄凉，但我相信一点：大家都在用一颗颗滚烫的爱心在热切的祝福我，安慰我，给我壮行.......多个送行的桌上，不少人掩面而涕，我第一次感到人性的复苏，心里距离的拉近，大有生死离别之感！正是这一刻，我感觉作为一个人的价值所在，只有当你心底无私，只有当你为心胸坦荡，只有当你默默奉献，只有当你乐于助人，你才能感受这一切人生的美好！ 我真心期望：忘了吧，勾心斗角的官场！忘了吧，争权多利的政治！忘了吧，过水烟云的名利....... 我不能堕落，更不能消沉，更不能脆弱，我应该选择坚强......... 多少次，上帝告诉我，当给你关闭这扇门的时候，-他已经给你打开了一扇窗！ 是啊，回想过去，上帝在给我痛苦和考验的同时，更多的是给我无限的恩惠：他让我成为最年轻的研究员；他让我成功完成了我日日梦想人生最高的学位；他让我成功发表了20多篇有价值的论文，并走向世界；他让我在年富力强的时候不失时机地给我出国深造的机会，让我梦想成真！更为重要的是：上帝给了我无数助我成长的恩师领导，给了我两肋插刀的“狐朋狗友”，我的人生因此而精彩！ 还有更令人欣喜的：上帝给了我无数的家庭幸福，慈爱的父母双亲，和睦的兄弟姊妹，温柔的漂亮贤妻，天真的可爱宝贝，我拥有了世界上几乎最美好的........ 再见了，痛苦不堪的日子！再见了，思绪过重的人生！为了心爱的人，为了爱我和我心爱的人，我要欢笑每一天！
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