Article title: Job Satisfaction of Senior Medical Interns: A Cross-Sectional Study
Author information: Jasmin Bengbeng, Jerome Manzano, Jesus Soriano Jr., Erel Christian
Gongora, Vincent Siquian, John Carlo Teodoro, Jules Verne Villanueva, Khristine Garcia, Justin
Maisie Ginete, Vernaliza Pasol
Disclaimers: The views and ideas expressed in this article are of the authors’ and not an official
position of Saint Louis Medicine-School of Medicine or any institution thereof.
Source (s) of support: Saint Louis University-School of Medicine, Saint Louis UniversityHospital of the Sacred Heart, Baguio General Hospital-Medical Center
Word count: 3702
Number of figures and tables: 4
Conflict of interest declaration: None disclosed
ABSTRACT
Background: Satisfaction is a measurable indicator of work adjustment that indicates how well
a person’s abilities and needs correspond to his working environment. Job satisfaction in the
field of medicine plays a critical role as it mirrors higher quality of patient care.
Objective: To determine the level of job satisfaction among medical senior interns currently
working in Baguio General Hospital- Medical Center (BGH-MC) and Saint Louis UniversityHospital of the Sacred Heart (SLU-HSH).
Design: Cross-sectional study design.
Setting: Questionnaires were directly administered to 37 senior medical interns of BGH-MC and
42 senior medical interns of SLU-HSH.
Participants: Senior medical interns from two training hospitals in Baguio City grouped into
two based on hospital affiliation.
Measurements: The general level of job satisfaction for all respondents was determined using
Minnesota Satisfaction Questionnaire Manual (short form). The scores of the 20-item
questionnaire were summed up and were converted to percentage scores to determine the
corresponding level of satisfaction.
Results: Majority of senior medical interns in Baguio General Hospital-Medical Center and
Saint Louis University-Hospital of the Sacred Heart has high level of job satisfaction (49.37%).
There is no significant difference between age (p value0.6361), gender (p value 0.9143), marital
status (p value0.2243), departmental rotation (p value 0.5072), hospital affiliation (p
value0.3099) and the level of job satisfaction of all respondents.
Limitations: Respondents were restricted to SLU- School of Medicine only not all departments
were properly represented.
Conclusion: Majority of the senior medical interns currently rotating in Baguio General
Hospital-Medical Center (BGH-MC) and Saint Louis University- Hospital of the Sacred Heart
(SLU-HSH) has average to high level of job satisfaction.
INTRODUCTION
Human power is the back bone for the provision of quality health care for the population.
High level of professional satisfaction among health workers earns high dividends such as higher
worker force retention and patients satisfaction. Job satisfaction is a measure to gauge the
performance of an individual at the workplace. It is the affective orientation that an employee has
towards his work that results from the perception that one’s job fulfils or allows the fulfillment of
one’s own important job values. It influences the quality of health care services which can be
looked upon its association to appropriate prescribing practices, patient adherence and greater
patient satisfaction.
Physician satisfaction has been found to strongly correlate with patient satisfaction and
desirable patient outcomes. Dissatisfied physicians on the other hand may be more likely to
unionize, to strike, to experience medical problems themselves and to exit medicine altogether,
as far as it may increase the rates of medical errors, thus jeopardizing patient safety1. Job
satisfaction influences the quality of health care services. Greater physician satisfaction is
associated with appropriate prescribing practices, patient adherence and greater patient
satisfaction2. The major reasons reported for dissatisfied healthcare professionals were lack of
motivation, inadequate salary, insufficient training opportunities and inadequate number of
human resources3.
Among young physicians especially those in the post-graduate training, stress at work
especially when being experienced over a longer period has its negative impact on the health and
life satisfaction along with the risk of developing symptoms of burnout in the long run4. It can be
supported by a study among third-year medical students at the Mount Sinai School of Medicine
(MSSM) in New York, where it has been found out that burnout is already present at the
beginning of the third year of medical school, prior to the initiation of the clinical years of
medical training5. From this, the researcher’s interest had been placed more on the senior intern
health providers, the ones who are on their way of establishing a stable career as physicians.
Many studies had been conducted among healthcare professionals in general but only few dealt
with medical interns. The factors aside from burnout, which can lead to their dissatisfaction or
satisfaction has not yet been well established. Knowing the difference in job satisfaction among
senior interns working in a private and in a public hospital helps the scientific community to
identify possible sources of distress for both groups and suggest manners on how to approach
this problem. It may also help medical school faculty, residents, and residency directors to
provide medical students with appropriate career counseling, enable medical group managers and
policy makers to anticipate workforce trends, and provide practicing physicians with interesting
information that could potentially influence career and retirement decisions.
This study, therefore, aims to determine the level of job satisfaction among medical
senior interns currently working in Baguio General Hospital- Medical Center (BGH-MC) and
Saint Louis University- Hospital of the Sacred Heart (SLU-HSH) and specifically, to determine
the association of gender, age, marital status and department they were assigned and to determine
if there are significant differences on the job satisfaction between the two groups of medical
interns.
METHODS
Study design
The study utilized a cross-section study design.
Setting
The study was conducted in two training hospitals in Baguio City namely BGH-MC and
SLU-HSH. Floating of questionnaires was done 1st week of January and was followed a week
after. The questionnaires were administered directly to all respondents.
Participants
The participants were senior medical students with the following inclusion criteria: (a)
senior medical interns of Saint Louis University Academic Year 2013-2014, and (b) senior
medical interns rotating at Baguio General Hospital-Medical Center (BGH-MC) and Saint Louis
University – Hospital of the Sacred Heart (SLU-HSH). Senior Medical Interns having their
rotation other than BGH-MC and BSLU-HSH and those rotating at BGH-MC and SLU-HSH but
graduated from other medical schools were excluded from this study.
Variables
The general job satisfaction for each respondent was determined. Potential effect
modifiers include age, gender, marital status, department affiliation and the hospital at the time
the questionnaires were floated.
Data sources/measurement
A questionnaire for determining level of job satisfaction was adopted from the Minnesota
Satisfaction Questionnaire Manual (short form) by David J. Weiss et al.
Bias
To address potential bias, the respondents were randomly selected for both groups 1 and
2 until the desired sample size was attained, and the Minnesota Job Satisfaction Questionnaire
Manual was strictly utilized for categorizing the level of job satisfaction.
Study size
The participants were grouped according to the hospital where they were having their
rotations. BGH-MC interns were assigned as Group 1 while the SLU-HSH interns as Group 2.
Total number of senior interns (2013-2014) particularly those rotating in BGH-MC (Group 1)
and SLU-HSH (Group 2) were obtained from the current roster available in the School of
Medicine Office, SLU with the following figures: Group 1=46 and Group 2=40. A sample size
of 42 for Group 1 and 37 for Group 2 were determined using the OpenEpi Software®.
Quantitative variables
The general job satisfaction for each respondent was determined using the short form
Minnesota Satisfaction Questionnaire, composed of twenty items. Each item referred to a
reinforcer in the work environment. The respondent indicated how satisfied he was with the
reinforcer in his present job. Five response alternatives were presented for each item: “Very
Dissatisfied; Dissatisfied; Neither (dissatisfied nor satisfied); Satisfied; Very Satisfied.” The
questionnaires were administered directly to all respondents.
Statistical methods
The general job satisfaction for each respondent was determined by summing up the
scores of all the 20 items in the questionnaire. The total raw scores were converted to percentile
scores, using the tables of normative data appropriate to the study’s respondents. A percentile
score of 75 or higher was taken to represent a high degree of satisfaction; a percentile score of 25
or lower represented a low level of satisfaction; and scores in the middle range of percentiles
(26-74) indicated average satisfaction.
The frequency and percentage of the data was analyzed using Epi.Info 3.5.2.
RESULTS
Indicators of Satisfaction
A frequency mean of 71.4 and a percentage mean of 90.4% are very satisfied or satisfied
with their job. A frequency mean of 3.5 and percentage mean of 4.4% are dissatisfied with their
job.77 out of 79 (97.47%) are very satisfied with their job in terms of the thought of having the
chance to do things for other people (social service). While 6 out of 79 (7.59%) are dissatisfied
with their job in terms of the freedom to use their own methods of doing the job (responsibility),
the way their co-workers get along with each other and the feeling of accomplishment they get
from their job (achievement). 10 out of 79 (12.66%) have a neutral level of job satisfaction in
terms of the way hospital policies are put into place (policy and practice).
Age and Level of Job Satisfaction
Respondents are grouped into two based on age, those who belong to 23-26 year old and
those of 27-30 year old. Of the 89 respondents, 52.63% of the 23-26 year old has low/average
satisfaction, and 47.37% has high satisfaction. 54.54% of those 27-30, however, has high
satisfaction, and 45.46% has low/average satisfaction.
Gender and Level of Job Satisfaction
50.00% of males has high satisfaction while 50.00% also has low/average satisfaction.
51.22% of females, on the other hand has low/average satisfaction, and 48.78% has high
satisfaction.
Marital status and Level of Job Satisfaction
Among the single respondents, 52.78% has low/average satisfaction and 47.22% has high
satisfaction. Among the married respondents, 71.43% has high satisfaction and 28.57% of
low/average satisfaction.
Department Rotation and Level of Job Satisfaction
In the department of pediatrics, 73.33% of senior medical interns has low/average
satisfaction. In Surgery, 57.14% has high satisfaction, in medicine 53.33% has high satisfaction,
in both Departments of EENT and OB-Gyne 50.00% has high satisfaction and 50.00% has
low/average satisfaction, while in Community Medicine 61.54% has high satisfaction.
Hospital affiliation and Level of Job Satisfaction
Among the senior medical interns rotating in BGH-MC, 54.76% has high satisfaction and
45.24% has low/average satisfaction. In SLU-HSS, however, 56.76% has low/average
satisfaction, while 43.24 has high satisfaction.
DISCUSSION
The results of this study shows that overall, the level of job satisfaction among medical
senior interns currently working in Baguio General Hospital- Medical Center (BGH-MC) and
Saint Louis University- Hospital of the Sacred Heart (SLU-HSH) is HIGH (f= 39 or 49.37%) as
revealed in Table 2: Level of Job Satisfaction. To answer the second objective, Table 4: Level of
Job Satisfaction Based on Different Variables surprisingly showed no significant difference as to
Age (p-value=0.6361), Gender (p-value=0.9143), Marital Status (p-value=0.2243), and
Departmental Rotation (p-value=0.5072). Lastly, Contrary to expectations, this study did not
find a significant difference on the job satisfaction between medical interns having training in a
public hospital (BGH-MC) and in a private hospital (SLU-HSH) (p-value=0.3099) Though this
study has its own limitations like limitation of respondents to senior medical interns who
graduated in SLU-School of Medicine and to those who are present in the hospital of interest
during the administration of questionnaires only.
This indicates that despite the stressful work of a medical intern and add to that the
pressure they get from their residents and consultants, more than half answered satisfied/very
satisfied on the different satisfaction indicators indicating that the medical interns are happy on
their work. However, the findings of the current study do not support the previous research,
Brayfield and Crockett6 performed the first meta-analysis in regard to the relationship between
job satisfaction and job performance and only obtained a weak correlation between the two
variables of 0.15.
Thirty years later Petty et al7 conducted another meta-analysis which demonstrated a
slightly higher correlation of 0.31.
The most influential and most extensive meta-analysis, conducted by Iaffaldano and
Muchinsky8 resulted in an overall average correlation of 0.17 between job satisfaction and job
performance.
Jae VandenBerghe9 on the basis of all these meta-analyses we can safely conclude that
the correlation between job satisfaction and job performance is unsubstantial and modest at best.
Causal direction studies did not come up with conclusive results in regard to the nature of the
relationship between job satisfaction and job performance.
This study has been unable to demonstrate that Lefkowitz10 analyzed a number of studies
and discovered that women's job satisfaction is in average lower than men's. One explanation for
this phenomenon could be that women are less invested in their work, since women's incomes
are, or at least used to be, merely the second income in the household. Another, more likely,
reason would be that women experience less job satisfaction because they tend to have less good
jobs overall compared to men. In a follow-up study Lefkowitz10 confirmed this reasoning by
demonstrating that the differences between men and women in the level of job satisfaction
disappeared when variables such as age, education, income and status were kept equal between
men and women11.
However, the findings of the current study do not support the previous research on age as
a factor on job satisfaction. According to some research job satisfaction tends to increase
throughout working life. Several reasons could be accountable for that 11older people have better
jobs than younger people, since, due to a longer career, they had more chances to obtain a
desirable job; older people have adjusted their expectations downwards over the years and they
are therefore more easily contempt; the older generation as a whole has always been more
satisfied; dissatisfied older people are more likely to opt for early retirement, while the remaining
older people are satisfied with their job. This creates a skewed image of the level of job
satisfaction among older people by cancelling out the dissatisfied segment.
Clarke12 discovered a U-shaped correlation between job satisfaction and lifespan. Job
satisfaction starts out reasonably high in teenage years, then takes a nosedive in the twenties and
thirties – with the age of 36 as the lowest point (in average) -, then it rises back up again through
the forties and further in the fifties and sixties13.
More than half of the respondents answered very satisfied/ satisfied on the supervision
(93.67%) and coworkers (87.34%) This finding corroborates the idea of Jae VandenBerghe9 who
suggested that influence of others in the work place on job satisfaction is significant. However, it
should be noted that not every- one is equally prone to the influence of others. There are
individual differences which can be attributed to differences in personal dispositions.
Griffin’s and Bateman’s14 research in this field revealed strong, positive correlations
between behavior exhibited by leaders and job satisfaction13. Weiss15 discovered great similarity
in values between employees and supervisors when the latter treated their subordinates with
consideration16.
This comparative study may still provide help to medical school faculty, residents, and
residency directors to provide medical students with appropriate career counseling, enable
medical group managers and policy makers to anticipate workforce trends, and provide
practicing physicians with interesting information that could potentially influence career and
retirement decisions.
CONCLUSION
This research has explained the central importance of a high level of job satisfaction
among senior medical interns in delivering patient care. The goal is to determine the level of job
satisfaction among medical senior interns currently working in Saint Louis University- Hospital
of the Sacred Heart (SLU-HSH) and Baguio General Hospital- Medical Center (BGH-MC) and
specifically, to determine the association of gender, age, marital status and department assigned
to them, and to determine if there are significant differences on the job satisfaction between the
two groups of medical interns. The most obvious finding to emerge from the research is the
average to high level of job satisfaction among the respondents. Age, gender, marital status,
departmental rotation, the type of training institutions, appear to have less significant effects on
the level of job satisfaction. In general, therefore, it seems that the average to high level of job
satisfaction despite the high level of difficulty of the nature of their job could indicate emotional
wellness or mental fitness. Although the research is based on a small sample of respondents, it
will serve as a base for future studies to be conducted in other regions of the country to also
investigate other variables that could also affect the level of job satisfaction, as necessary.
Moreover, a follow-up study could also investigate if the average to high level of job satisfaction
among the respondents translates to a high level of patient satisfaction.
References
1. Leigh JP, Kravitz RL, Schembri M, Samuels SJ, Mobley S. Physician Career Satisfaction
Across Specialsties. Arch Intern Med. 2002; 162(1577): 1577-1584.
2. Abdullah A, Nahla K.. Job Satisfaction Among Primary Health Care Physicians and Nurses
in Al-Madinah Al-Munawwara. JEPHAss. 2006; 81: 1-15.
3. Alemshet Y, Leja H, Alima H , Challi , Morankar S. Job Satisfaction and Its Determinants
Among Health Workers in Jimma University Specialized Hospital, Southwest Ethiopia.
Ethiop J Health Sci. August 2011; 21(Suppl 1): 19-27.
4. Budderberg-Fischer , Stamm M, G B, Hammig O, Klaghofer R. Work stress, health and
satisfaction of life in young doctors. Resuts of a Longitudinal Study in Switzerland. Pub
Med. 2008; 133(47): 2441-2447.
5. Mazurkiewicz R, Korenstein D, Fallar R, Ripp J. The Prevalence and Correlations of
Medical Student Burnount in the Pre-clinical Years: a cross-sectional study. Psychol Health
Med. 2012; 17(2): 188-95.
6. Brayfield AH, Crockett WH. Employee Attitudes and Employee Performance. Psychological
Bulletin. 1955; 52: 396-424.
7. Petty MM, McGee GW, Cavender JW. A meta-analysis of the relationships between
individual job satisfaction and individual performance. Academy of Management Review.
1984; 9: 712-21.
8. Iaffaldano MT, Muchinsky PM. Job Satisfaction and Job Performance: A meta analysis.
Psychological Bulletin. 1985; 97: 251-273.
9. Berghe JV. Job Satisfaction and Job Performance at the Work Place. Arcada. 2011;: 51.
10. Lefkowitz J. Sex-related differences in Job Attitudes and Dispositional Variables: Now you
see them. Academy of Management Journal. 1994; 37(2): 323-349.
11. Mckenna E. Business Psychology and Organisational Behavior. Taylor & Francis Inc, New
York. 2000.
12. Clarke AE. Job satisfaction in Britain. British Journal of Industrial Relations. 1996; 34(1):
189-217.
13. Arnold J, Cooper CL, Robertson IT. Work psychology: Understanding human behavior in
the workplace. Harlow, England: Person Education. 1998;: 23.
14. Griffin RW, Bateman TS. Job Satisfaction and Organizational Commitment. Defense
Technical Information Center. 1985;: 100.
15. Weiss DJ. Deconstructing Job Satisfaction: Separating evaluations, beliefs and affective
experiences. Human Resource Management Review. 1967; 12: 173-194.
16. Furnham A, Eracleous A, Chamorro-Premuzic T. Personality, motivation and job
satisfaction: Hertzberg meets the Big Five. Emerald Group Publishing Limited. 1992; 24(8):
765-779.
Table 1: Demographic Profile of Respondents
Demographic Profile
Frequency
(n=79)
Percentage
57
22
72.15%
27.85%
38
41
48.10%
51.90%
72
7
91.14%
8.86%
15
14
15
6
16
13
18.99%
17.72%
18.99%
7.59%
20.25%
16.46%
42
37
53.16%
46.84%
AGE
23 – 26 y/o
27 – 30 y/o
GENDER
Male
Female
MARITAL STATUS
Single
Married
DEPARTMENTAL ROTATION
Pediatrics
Surgery
Medicine
EENT
OB-Gyne
Community Medicine
HOSPITAL AFFILIATION
BGH-MC
SLU-HSH
Table 2: Level of Job Satisfaction
Job Satisfaction
Frequency
n=79
Percentage
LOW
6
7.59%
AVERAGE
34
43.04%
HIGH
39
49.37%
Table 3. Frequency and Percentage for Each Level of Job Satisfaction Indicator
Very Satisfied /
Neutral (N)
Very Dissatisfied /
Indicators
Satisfied
Dissatisfied
Mean=71.4 (90.4%)
Mean=4.1 (5.2%)
Mean=3.5 (4.4%)
Frequency Percentage Frequency Percentage Frequency Percentage
1. ACTIVITY. Being able
72
91.14%
5
6.33%
2
2.53%
to keep busy all the time.
2. INDEPENDENCE. The
67
84.81%
8
10.13%
4
5.06%
chance to work alone on
the job.
3. VARIETY. The chance
73
92.41%
2
2.53%
4
5.06%
to do different things from
time to time.
4. SOCIAL STATUS. The
73
92.41%
3
3.80%
3
3.80%
chance to be “somebody”
in the community.
5. SUPERVISION
–
73
92.41%
1
1.27%
5
6.33%
Human Relations. The
way my superior handles
his/her workers.
6. SUPERVISION
–
74
93.67%
2
2.53%
3
3.80%
Technical.
The
competence
of
my
supervisor in making
decisions.
7. MORAL VALUES.
74
93.67%
2
2.53%
3
3.80%
Being able to do things
that don’t go against my
conscience.
8. SECURITY. The way
72
91.14%
7
8.86%
0
0.00%
my job provides for steady
employment.
9. SOCIAL SERVICE.
77
97.47%
2
2.53%
0
0.00%
The chance to do things
for other people.
10. AUTHORITY. The
74
93.67%
4
5.06%
1
1.27%
chance to tell people what
to do.
11.
ABILITY
75
94.94%
1
1.27%
3
3.80%
UTILIZATION.
The
chance to do something
that makes use of my
abilities.
12.
POLICY
AND
64
81.01%
10
12.66%
5
6.33%
PRACTICE. The way
hospital policies are put
into practice.
13. COMPENSATION.
My benefits and the
amount of work I do.
14.
ADVANCEMENT.
The
chances
for
advancement on this job.
15. RESPONSIBILITY.
The freedom to use my
own methods of doing the
job.
16. CREATIVITY. The
chance to try my own
methods of doing the job.
17.
WORKING
CONDITIONS.
The
working conditions.
18. CO-WORKERS. The
way my co-workers get
along with each other.
19. RECOGNITION. The
praise I get for doing a
good job.
20.
ACHIEVEMENT.
The
feeling
of
accomplishment I get
from the job.
68
86.08%
7
8.86%
4
5.06%
72
91.14%
4
5.06%
3
3.80%
69
87.34%
4
5.06%
6
7.59%
70
88.61%
5
6.33%
4
5.06%
69
87.34%
6
7.59%
4
5.06%
69
87.34%
4
5.06%
6
7.59%
70
88.61%
4
5.06%
5
6.33%
73
92.41%
1
1.27%
6
7.59 %
Table 4: Level of Job Satisfaction Based on Different Variables
Variables
AGE
23 – 26 y/o
27 – 30 y/o
GENDER
Male
Female
MARITAL
STATUS
Single
Married
DEPARTMENT
AL ROTATION
Pediatrics
Surgery
Medicine
EENT
OB-Gyne
ComMed
HOSPITAL
AFFILIATION
BGH-MC
SLU-HSH
Level of Job Satisfaction
LOW / AVERAGE
HIGH
Frequency Percentage Frequency Percentage
x²
(d.f.)
p-value
30
10
52.63%
45.46%
27
12
47.37%
54.54%
0.2239 (1)
0.6361
19
21
50.00%
51.22%
19
20
50.00%
48.78%
0.0116 (1)
0.9143
38
2
52.78%
28.57%
34
5
47.22%
71.43%
11
6
7
3
8
5
73.33%
42.86%
46.67%
50.00%
50.00%
38.46%
4
8
8
3
8
8
26.67%
57.14%
53.33%
50.00%
50.00%
61.54%
19
21
45.24%
56.76%
23
16
54.76%
43.24%
1.4766 (1)
4.2994 (5)
1.0309 (1)
0.2243
0.5072
0.3099