Search

Background The prevalence of burnout and depressive symptoms is high among physician trainees. Research Question What is the burden of burnout and depressive symptoms among fellows training in pulmonary and critical care medicine (PCCM) and what are associated individual fellow, program, and institutional characteristics? Study Design and Methods We conducted a cross-sectional electronic survey of fellows enrolled in pulmonary, PCCM, and critical care medicine training programs in the United States to assess burnout and depressive symptoms. Burnout symptoms were measured using the Maslach Burnout Index two-item measure. The two-item Primary Care Evaluation of Mental Disorders Procedure was used to screen for depressive symptoms. For each of the two outcomes (burnout and depressive symptoms), we constructed three multivariate logistic regression models to assess individual fellow characteristics, program structure, and institutional polices associated with either burnout or depressive symptoms. Results Five hundred two of the 976 fellows who received the survey completed it—including both outcome measures—giving a response rate of 51%. Fifty percent of fellows showed positive results for either burnout or depressive symptoms, with 41% showing positive results for depressive symptoms, 32% showing positive results for burnout, and 23% showing positive results for both. Reporting a coverage system in the case of personal illness or emergency (adjusted OR [aOR], 0.44; 95% CI, 0.26-0.73) and access to mental health services (aOR, 0.14; 95% CI, 0.04-0.47) were associated with lower odds of burnout. Financial concern was associated with higher odds of depressive symptoms (aOR, 1.13; 95% CI, 1.05-1.22). Working more than 70 hours in an average clinical week and the burdens of electronic health record (EHR) documentation were associated with a higher odds of both burnout and depressive symptoms. Interpretation Given the high prevalence of burnout and depressive symptoms among fellows training in PCCM, an urgent need exists to identify solutions that address this public health crisis. Strategies such as providing an easily accessible coverage system, access to mental health resources, reducing EHR burden, addressing work hours, and addressing financial concerns among trainees may help to reduce burnout or depressive symptoms and should be studied further by the graduate medical education community.

Background Recent literature has implicated dairy as having a potential acne-inducing effect. Objectives The aim of this study was to investigate the link between dairy consumption and acne in teenagers. We tested the hypothesis that teenagers with facial acne consume more dairy than those without acne. Methods A case-control study was conducted among 225 participants, ages 14 to 19 years, with either moderate acne or no acne. Moderate acne was determined by a dermatologist using the Global Acne Assessment Scale. Participants who met inclusion criteria then completed up to three 24-hour diet recall interviews using the Nutrition Data System for Research software and food and nutrient intake were compared between groups. Results The amount of low-fat/skim milk consumed by participants with acne with significantly higher ( P = .01) than those with no acne. No significant difference was found among total dairy intake, saturated fat or trans-fat, or glycemic load. No significant difference was found for total energy intake or body mass index. Limitations Limitations include self-report of diet and portion size, and association does not determine causation. Conclusions Consumption of low-fat/skim milk, but not full-fat milk, was positively associated with acne.