BACKGROUND Burnout syndrome was defined in the 1970s as a triad of emotional exhaustion (EE), depersonalization (DP), and a low sense of personal accomplishment (PA). 1 Almost half of physicians report burnout, and emergency physicians (EP) are near the top of the list. 2 In 2018, 48% of EPs reported burnout. 3 Physician burnout has been shown to negatively correlate with patient safety, quality of care, physician professionalism, and patient satisfaction. 4,5 In EPs, burnout was associated with increased frequency of self-reported, suboptimal patient care, including admitting or discharging patients early, not communicating effectively with patients, ordering more tests, not treating patients' pain, and not communicating important handoffs. 6 Additionally, burnout has been associated with substance use, relationship issues, depression, and suicide. 5,7,8 Originally, burnout was believed to manifest in those who practiced medicine for a prolonged amount of time. However, recent evidence has shown that burnout may begin as early as medical school and residency. 9-10 In fact, recent studies on emergency medicine (EM) residents reported burnout rates ranging from 65-76%. 9,11 Across all fields of medicine, residents have shown higher rates of burnout when compared to medical students and early-career physicians. 9,10 In response to this data indicating early onset of burnout,
BackgroundA gender gap in faculty rank at academic institutions exists; however, data among graduate medical education (GME) programmes are limited. There is a need to assess gender disparities in GME leadership, as a lack of female leadership may affect recruitment, role modelling and mentorship of female trainees. This cross-sectional study aimed to describe the current state of gender in programme leadership (department chair, programme director (PD), associate/assistant PD (APD) and clerkship director (CD)) at accredited Emergency Medicine (EM) programmes in the USA to determine whether a gender gap exists.MethodsA survey was distributed to EM residency programmes in the USA assessing demographics and gender distribution among programme leadership. If no response was received, information was collected via the programme’s website. Data were organised by position, region and length of the programme. We obtained data on the number of female EM physicians in practice and in training/fellowship in 2017 from the Association of American Medical Colleges. Data analysis was completed using descriptive statistics and χ2 analysis.ResultsOf the 226 programmes contacted, 148 responded to the survey (66.3%). Among US EM residency programmes, 11.2% of chairs, 34.6% of PDs, 40.5% of APDs and 46.5% of CDs are women. The percentage of female chairs is significantly lower than the percentage of women in practice or in training in EM. The percentage of female PDs did not differ from the percentage of women in practice or in training in EM. The percentage of female APDs and CDs was significantly higher than the percentage of women in practice but did not differ from the percentage in training. There was wide variability across regions. Four-year programmes had more women in PD and APD positions compared with 3-year programmes (p=0.01).ConclusionsWhile the representation of women in educational roles is encouraging, the number of women holding the rank of chairperson remains disproportionately low. Further studies are needed to evaluate reasons for this and strategies to increase gender equality in leadership roles.
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