title: Children, care, career - a cross-sectional study on the risk of burnout among German hospital physicians at different career stages.
abstract: BACKGROUND
  With the increasing number of female medical students physicians' need for work-life balanced hospital jobs rises at all career stages. The Working Time Act (Arbeitszeitgesetz, ArbZG), an implementation of the European Working Time Directive into German law in 2004, should have improved the general conditions for creating flexible work. Nevertheless, the vast majority of female physicians still report an incompatibility of work and family. So far, little is known about mothers working on leading positions in the medical field. The presented study focuses on gender differences in the level of emotional exhaustion between child-rearing junior and senior physicians and different predictors of burnout.
  
  
  METHODS
  Three years after the ArbZT-enactment, 994 physicians from the listed hospital physicians in the Medical Register of the city of Hamburg participated in the cross-sectional study and completed a 60-item questionnaire (return rate of 46,5%). The questionnaire included a 22-item version of the German translation of the Maslach Burnout Inventory whereat emotional exhaustion was interpreted as the crucial predictor of burnout. Results of an univariate covariance analysis and regression analyses are reported.
  
  
  RESULTS
  In the level of emotional exhaustion no gender differences were found between junior and senior physicians with children in the overall analysis. Support by the superior was the only overall predictor of burnout. Female senior physicians having children presented the highest risk of burnout. Only in this group parenting contributed significantly to the risk of burnout.
  
  
  CONCLUSIONS
  Support by the superior and the relationship to colleagues are generally important predictors of burnout among hospital physicians. Parenthood only gets a crucial influence on psychomental health for female senior physicians. Still conservative role models are common in this group, thus dealing with the triple burden of work, leadership responsibility and child rearing seems to be a special female challenge. Innovative approaches of human resource policy need to be implemented to improve the reconciliation of family and working life.
authors.affiliation: Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf, Seewartenstraße 10, Haus 1, 20459 Hamburg, Germany.
authors.forename: Astrid
authors.initials: A
authors.lastname: Richter
authors.affiliation: Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf, Seewartenstraße 10, Haus 1, 20459 Hamburg, Germany.
authors.forename: Petya
authors.initials: P
authors.lastname: Kostova
authors.affiliation: Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf, Seewartenstraße 10, Haus 1, 20459 Hamburg, Germany.
authors.forename: Volker
authors.initials: V
authors.lastname: Harth
authors.affiliation: Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf, Seewartenstraße 10, Haus 1, 20459 Hamburg, Germany.
authors.forename: Ralf
authors.initials: R
authors.lastname: Wegner
keywords: Burnout; Gender; Hospital physicians; Leadership; Work-family conflict