Prevalence of and Factors Associated with Burnout in Pediatric Urology Fellows
Gwen M. Grimsby, MD.
Phoenix Children's, Phoenix, AZ, USA.
BACKGROUND: The 2016 AUA census found that 39% of practicing urologists experienced burnout. Burnout is described as a syndrome of emotional exhaustion, depersonalization, and decreased feelings of personal accomplishment due to workplace stress. Despite the demands of training, little is known about the prevalence of burnout in pediatric urology fellows. The goal of this study was to determine the prevalence of burnout in pediatric urology fellows and determine factors associated with higher levels of burnout.
Methods: The Maslach Burnout Inventory (MBI) and an anonymous survey of personal and training characteristics were distributed electronically to current pediatric urology fellows. The MBI is a standardized and validated 22-item questionnaire used to quantify burnout and is comprised of three subscales: Emotional Exhaustion (EE), Depersonalization (DP), and Personal Accomplishment (PA). As per prior literature, higher scores in EE (>27) or DP (>10) were defined as high burnout. Demographic and training characteristics were compared between fellows with high and low to moderate levels of burnout with t tests and Fischer’s exact tests.
Results: The survey response rate was 77% (27/34); 48% were clinical fellows, 52% were research fellows. Mean age of respondents was 34 years (SD 2.6), 59% were female, 70% married, and 37% the parent of one or more children. The mean scores for EE, DP, and PA were 15 (SD 10.2), 4 (SD 4.0), and 39 (SD 10.3), respectively, with no significant difference between year in fellowship. Nineteen percent of fellows met criteria for high burnout and 41% met criteria for moderate to high burnout based on EE or DP scores. Factors significantly associated with high burnout included number nights of call per month and number of projects required to complete in fellowship, Table 1. There was no significant difference in age, gender, family factors, or mentorship while in fellowship between those with high and low to moderate burnout scores, Table 1.
Conclusions: Nearly twenty percent of pediatric urology fellows scored for high levels of burnout and over 40% scored for moderate to high levels of burnout. There appears to be an association with increased call and project workload requirements with increased levels of burnout, and efforts to combat burnout could specifically address these factors.
| Table 1 | Low to Moderate BurnoutN=22 | High burnoutN=5 | P value |
| MIBI EE; mean (SD) | 11.9 (6.7) | 30.2 (10.2) | <0.0001 |
| MIBI DP; mean (SD) | 2.6 (2.4) | 9.4 (5.1) | <0.0001 |
| MIBI PA; mean (SD) | 39.7 (10.6) | 36.2 (9.6) | 0.5074 |
| Clinical year; n(%) | 9 (41) | 4 (80) | 0.1647 |
| Age in years; mean (SD) | 34 (2.8) | 34 (1.3) | 0.5953 |
| Male; n(%) | 9 (41) | 2 (40) | 1.0000 |
| Married; n(%) | 15 (68) | 4 (80) | 1.0000 |
| Children; n(%) | 9 (41) | 1 (20) | 0.6210 |
| Pets; n(%) | 13 (59) | 3 (60) | 1.0000 |
| Family moved with you to fellowship n (%) | 11 (50) | 3 (60) | 1.0000 |
| Number of call days/month; mean (SD) | 4.7 (5.9) | 15.8 (10.0) | 0.0027 |
| Mentorship program in fellowship; n (%) | 10 (45) | 2 (40) | 1.0000 |
| Number of projects to complete during fellowship; mean (SD) | 1.6 (1.0) | 3.7 (3.1) | 0.0281 |
| Hours of sleep per night; mean (SD) | 7.1 (1.0) | 6.4 (1.1) | 0.1709 |
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