1. A National Survey of Burnout and Depression Among Fellows Training in Pulmonary and Critical Care Medicine
- Author
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Scott M. Lieberman, Kristin M. Burkart, Kerry L. Neall, Schartess Culpepper Pace, Apostolos Kontzias, Judith A. Furlong, Morgan I. Soffler, Rahul G. Argula, Maria Danila, Mark H. Adelman, Joseph Barney, Lynn M. Petruzzi, Matthew C. Baker, Charles D. Burger, Chadwick R. Johr, Elliot Rosenstein, Robert Vassallo, Stephen Doyle, Gregory P. Downey, Gretchen Winter, Thomas Eckmann, Jeanne Dale, Richard A. Helmers, Stanley Pillemer, Alan Baer, Tamiko Katsumoto, Keith J. Robinson, Amit Sachdev, Robert M. Kotloff, Vasileios C. Kyttaris, Rendell W. Ashton, Rachana Krishna, Sara S. McCoy, Nora Sandorfi, Kristin A. Riekert, Stamatina J. Danielides, Elizabeth R. Volkmann, Heidi Kukla, Timothy Niewold, Donald Bloch, Jennifer W. McCallister, Michelle Sharp, Jerome L. Greene, Robert I. Fox, Malik M. Khurram S. Khan, Sandra E. Zaeh, Michelle N. Eakin, Kristen L. Veraldi, Stuart S. Kassan, Peter H. Lenz, Daniel J. Wallace, Evelyn J. Bromet, Edward L. Treadwell, Robert F. Spiera, Adrian Shifren, Theresa Lawrence Ford, W. Neal Roberts, Jacqueline O’Toole, Senada Arabelovic, Matthew Koslow, Janet Lewis, Philip Cohen, Rebecca C. Keith, Thomas G. Osborn, Sarah Schafer, Justin C. Hewlett, Paul F. Dellaripa, Scott Zashin, Ruben Peredo-Wende, Chokkalingam Siva, Jay H. Ryu, Jeffrey J. Swigris, Lee Daugherty Biddison, Cynthia S. Rand, Barbara Segal, Daniel Small, Gerald W. Staton, Thomas Grader-Beck, Ghaith Noaiseh, Frederick B. Vivino, Tracy Luckhardt, James Gagermeier, Robert W. Ward, James Topilow, Kirsten Koons, and Gabriel T. Bosslet
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Pulmonary and Respiratory Medicine ,Response rate (survey) ,medicine.medical_specialty ,business.industry ,health care facilities, manpower, and services ,Public health ,education ,Graduate medical education ,MEDLINE ,Burnout ,Critical Care and Intensive Care Medicine ,Mental health ,Odds ,03 medical and health sciences ,0302 clinical medicine ,030228 respiratory system ,Medicine ,030212 general & internal medicine ,Cardiology and Cardiovascular Medicine ,business ,Intensive care medicine ,psychological phenomena and processes ,Depression (differential diagnoses) - Abstract
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.
- Published
- 2021