Prevalence and risk factors for burnout in U.S. vascular surgery trainees

Burnout and suicidality are known risks for vascular surgeons above other surgical subspecialties, with surgical trainees at risk for exposure to factors that increase burnout. This study aimed to inform initiatives to improve wellness by assessing the prevalence of hazards in vascular training (mis...

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Bibliographic Details
Published in:Journal of vascular surgery 2022-01, Vol.75 (1), p.308-315.e4
Main Authors: Chia, Matthew C., Hu, Yue-Yung, Li, Ruojia Debbie, Cheung, Elaine O., Eng, Joshua S., Zhan, Tiannan, Sheahan, Malachi G., Bilimoria, Karl Y., Coleman, Dawn M.
Format: Article
Language:English
Subjects:
Burnout
Burnout, Professional - epidemiology
Burnout, Professional - prevention & control
Burnout, Professional - psychology
Career Choice
Cross-Sectional Studies
Female
Humans
Internship and residency
Internship and Residency - statistics & numerical data
Male
Medical education
Prevalence
Risk Factors
Sex Factors
Suicidal Ideation
Surgeons - education
Surgeons - psychology
Surveys and Questionnaires - statistics & numerical data
United States - epidemiology
Vascular Surgical Procedures - education
Vascular Surgical Procedures - psychology
Wellness
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Summary:Burnout and suicidality are known risks for vascular surgeons above other surgical subspecialties, with surgical trainees at risk for exposure to factors that increase burnout. This study aimed to inform initiatives to improve wellness by assessing the prevalence of hazards in vascular training (mistreatment, duty-hour violations) and the rates of wellness outcomes (burnout, thoughts of attrition/specialty change/suicide). We hypothesized that mistreatment and duty-hour violations would predispose trainees to increased burnout. We performed a cross-sectional study of residents and fellows enrolled in accredited United States vascular surgery training programs using a voluntary, confidential survey administered during the 2020 Vascular Surgery In-Training Examination. The primary outcome assessed was burnout symptoms reported on a weekly basis or more frequently. The rates of wellness outcomes were measured. The association of mistreatment and duty hours with the primary outcome was modeled with multivariable logistic regression. A total of 475 residents and fellows who were enrolled in one of 120 vascular surgery training programs completed the survey (84.2% response rate). Of 408 trainees completing burnout survey items, 182 (44.6%) reported symptoms of burnout. Fewer trainees reported thoughts of attrition (n = 42 [10.0%], specialty change (n = 35 [8.4%]), or suicide (n = 22 [4.9%]). Mistreatment was reported by 191 vascular trainees (47.3%) and was more common in female trainees (n = 63 [48.5%] reporting monthly or more frequently) compared with male trainees (n = 51 [18.6%]; P < .001). Duty-hour violations were also more commonly reported by female trainees (n = 31 [21.4%] reporting 3+ months in violation) compared with male trainees (n = 50 [16.2%]; P = .002). After controlling for race/ethnicity, postgraduate year, program type, and geography, female trainees were less likely to report burnout (odds ratio [OR], 0.49; 95% confidence interval [CI], 0.28-0.86). Trainees experiencing mistreatment monthly or more were three times more likely to report burnout (OR, 3.09; 95% CI, 1.78-5.39). Frequency of duty-hour violations also increased the odds of reporting burnout (1-2 months in violation: OR, 2.09; 95% CI, 1.17-3.73; 3+ months in violation: OR, 3.95; 95% CI, 2.24-6.97). Nearly one-half of vascular surgery trainees reported symptoms of burnout, which was associated with frequency of mistreatment and duty-hour violations. Interventions to improve well-b
ISSN:0741-5214
1097-6809
DOI:10.1016/j.jvs.2021.06.476