In Partial Fulfillment of the Requirement for the Degree Master of Science in Health Care Management

Assessment 

Introduction

Burnout in physicians has become one of the main concerns in the global healthcare systems, particularly among the physicians in the internal medicine department who have to face high administrative burdens, patient volumes and emotional demands (Basnawi, 2024). Saudi Arabia has its healthcare system divided into public (ministry of health) and private sector hospitals, each contributing to different working conditions, demands and support systems (Alqarni, 2022). This difference in structural and operational systems can influence the wellbeing of the physicians, job satisfaction levels and ultimately the care outcomes of the patients (Alqarni, 2022).

Burnout is often defined when characteristics like depersonalization, emotion exhaustion and a reduced sense of personal achievement is identified in an individual (Nápoles, 2022). This when seen in physicians can lead to increased medical errors, lower efficiency and productivity, and early retirements (Shin, 2023). However, job satisfaction plays an integral role in contributing to better retention rates, enhanced medical performance and improved relationships between the physician and the patient (Wang, 2022). It is essential to understand how burnout and job satisfaction interact within the different healthcare sectors in order to develop targeted interventions to support the wellness of physicians and to sustain the workforce for a long period of time (Dinibutun, 2023). 

Although there are numerous individual researches investigating the burnout and job satisfaction among the healthcare professionals in Saudi Arabia, there is a lack of consolidated evidence that is specifically creating a comparison of experiences between internal medicine professionals working at MOH and private hospitals. This research thus uses a systematic literature review process that offers a comprehensive and structured method to evaluate synthesize and analyze the current body of research to identify gaps, patterns, and implications for the policy and practice.

Literature Review

Researchers concluded different findings for burnout and job satisfaction levels in MOH and private hospital of Saudi Arabia. Burnout rates among the internal medicine physicians remains a growing concern in the public hospitals of Saudi Arabia, especially under the Ministry of Health, due to high environment and systemic stressors. According to Aldrees et al. (2023), the study conducted in a tertiary MOH hospital in Riyadh concluded that 70% of the physicians experienced extreme burnout, with the internal medicine physicians particularly at high risk due to long working hours causing severe body related issues like back pain and fatigue and also negative impacts were seen on their personal life outside of work. Similarly, Agha et al. (2015) study assessing the impact of burnout at public military hospital, found that 85% of the doctors, including those in internal medicine departments, experienced symptoms of burnout, with 68.8% suffering from emotional exhaustion.

Complementing these findings, the studies on job satisfaction further displays the evident challenges in public hospitals. Bahnassy et al. (2016) concluded that mean job satisfaction of the physicians including those in internal medicine, at tertiary care MOH hospitals was moderate (a 3.67/5 on scale) and was heavily influenced by factors like leave policy, salary and future opportunities. However, physicians with family responsibilities showed lower job satisfactions. Likewise, Bawakid et al. (2017), reported in his study that compared two MOH hospitals that only 45.5% of the physicians working in family or internal medicine were satisfied, due to high patient load, emotional exhaustion, limited administrative support and poor progressions in career as the main reasons for dissatisfaction. This comparison displays a clear link between burnout and jib satisfaction in the internal medicine physicians of the MOH public hospitals.

In contrast, the private sector physicians tend to show significant higher levels of job satisfaction and lower burnout levels. As noted by Abdulrahman et al. (2021), in a comparison of both private and public sector physicians in Saudi, found that physicians in the private sector were more satisfied with their work. It also stated that those in public sectors were likely to be 2.5 times more dissatisfied than their counterparts in the private sector.

Reserch Questions

What is the impact of burnout and job satisfaction on the internal medicine physicians working in public hospitals (MOH) to those working is private sectors in Saudi Arabia?

The question was coined out using the Population, Intervention, Comparison and Outcome (PICO) framework, where:

• Population (P)= Internal medicine physicians in Saudi Arabia
• Intervention (I)= Employment in public hospitals (MOH)
• Comparison (C)= Employment in private hospitals
• Outcome (O)= Burnout levels and job satisfaction

Research Objectives

1. To evaluate the prevalence and factors contributing to the burnout among internal medicine physicians in MOH public hospitals.
2. To assess the level of job satisfaction among internal medicine physicians in MOH public hospitals.
3. To compare the burnout and job satisfaction levels between the internal medicine physicians working at MOH and private sectors.
4. To identify the sector-specific work-related and organizational factors that influence the burnout and job satisfaction levels in internal medicine physicians.

Brief Summary of the Assessment Requirements

The assessment requires students to conduct a structured academic analysis on the topic of burnout and job satisfaction among internal medicine physicians in Saudi Arabia, comparing experiences between Ministry of Health (MOH) public hospitals and private sector hospitals.

The key expectations of the assessment include:

Core Requirements

• Develop a well-structured paper with a clear Introduction, Literature Review, Research Questions, and Research Objectives.
• Explain the problem of physician burnout and job satisfaction using existing literature, focusing on emotional exhaustion, depersonalization, and reduced personal accomplishment.
• Compare MOH and private sector hospitals using evidence from scholarly sources regarding working conditions, burnout levels, and job satisfaction.
• Use the PICO framework to define the research question clearly.
• Identify patterns, gaps, and sector-specific differences in the literature.
• Demonstrate critical understanding of how organizational conditions influence physician well-being.

Key Pointers to be Covered

• Definition and significance of physician burnout.
• Variations in burnout and job satisfaction across MOH and private hospitals.
• Role of workload, administrative pressures, family responsibilities, emotional exhaustion, and career advancement.
• Evidence-backed comparison using multiple studies.
• Clear articulation of aims and objectives.
• Synthesis of findings, not just description.

How the Academic Mentor Guided the Student A Step-by-Step Explanation

The academic mentor supported the student through each stage of developing the assessment, ensuring clarity, structure, and alignment with academic expectations.

Step 1: Understanding the Topic and Setting Direction

The mentor first explained the scope of the assignment physician burnout and job satisfaction and emphasized the importance of comparing MOH and private hospitals.
They helped the student understand the relevance of the topic to healthcare outcomes and workforce sustainability.

Step 2: Crafting the Introduction

The mentor guided the student to:

• Introduce burnout as a global healthcare concern.
• Explain differences between MOH and private hospital systems.
• Highlight why internal medicine physicians are at increased risk.
• Present the research gap: lack of comparative evidence between sectors.
• Establish the purpose of conducting a systematic literature review.

This set a strong foundation and aligned the introduction with academic expectations.

Step 3: Building the Literature Review

The mentor instructed the student to:

• Gather peer-reviewed studies focusing on burnout and job satisfaction among physicians in Saudi Arabia.
• Compare findings across MOH and private sectors.
• Highlight high burnout rates in MOH hospitals (e.g., long hours, poor administrative support, emotional exhaustion).
• Contrast these with higher satisfaction and lower burnout in private hospitals.
• Identify recurring factors: workload, workplace culture, career progression, emotional demand, support systems.
• Synthesize not just summarize the findings.

This helped the student produce a coherent and analytical literature review.

Step 4: Formulating the Research Question

The mentor helped shape a clear question using the PICO framework, ensuring it aligned directly with the assessment’s comparative nature.

Step 5: Defining Research Objectives

The mentor guided the student to formulate objectives that were:

• Specific
• Aligned with the literature
• Focused on MOH vs. private sector comparison
• Centered on both burnout and job satisfaction

These objectives provided direction for the analysis.

Step 6: Ensuring Academic Flow and Structure

The mentor reviewed each section to ensure:

• Logical progression
• Clarity of argument
• Proper transitions between sections
• Strong linkage between evidence, research question, and objectives

Step 7: Aligning with Academic Standards

The mentor emphasized:

• Critical evaluation instead of descriptive writing
• Evidence-based comparison
• Proper referencing (APA style)
• Maintaining an objective academic tone

Final Outcome and Learning Objectives Achieved

By following the mentor’s step-by-step guidance, the student successfully produced:

• A well-structured assessment with clear introduction, literature review, research question, and objectives.
• A thorough, comparative understanding of burnout and job satisfaction in MOH vs. private hospitals.
• A literature-synthesized perspective rather than a simple summary.
• A problem statement grounded in real-world healthcare challenges.
• A clearly justified research gap and purpose.

Learning Objectives Achieved

• Understanding how workplace factors contribute to physician burnout.
• Ability to analyze research findings and synthesize multiple sources.
• Skills in developing research questions using PICO.
• Competence in comparing sector-specific differences in healthcare environments.
• Ability to write academically structured, evidence-based assessments.
• Enhanced critical thinking regarding organizational influences on physician well-being.

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