A National Survey of Burnout and Depression Among Fellows Training in Pulmonary and Critical Care Medicine

Sharp, Michelle; Adelman, Mark H.; Ashton, Rendell W.; Biddison, Lee Daugherty; Bosslet, Gabriel T.; Doyle, Sarah; Eckmann, Thomas; Lenz, P; McCallister, Jennifer W.; O’Toole, Jacqueline; Rańd, Cynthia S.; Riekert, Kristin A.; Soffler, Morgan; Winter, Gretchen; Zaeh, Sandra E.; Eakin, Michelle N.; Arabelovic, Senada; Baer, Alan N.; Greene, Jerome L.; Baker, Matthew; Bloch, Donald A.; Cohen, Philip; Danielides, Stamatina J.; Danila, Maria I.; Dellaripa, Paul F.; Ford, Theresa Lawrence; Fox, Robert; Grader‐Beck, Thomas; Johr, Chadwick R.; Katsumoto, Tamiko; Kontzias, Apostolos; Koons, Kirsten; Kyttaris, Vasileios C.; Lewis, Janet; McCoy, Sara S.; Niewold, Timothy B.; Noaiseh, Ghaith; Osborn, Thomas G.; Pace, Schartess Culpepper; Peredo-Wende, Ruben; Pillemer, Stanley R.; Roberts, W. Neal; Rosenstein, Elliot D.; Sachdev, Amit; Sandorfi, Nora; Segal, Barbara A; Siva, Chokkalingam; Small, Daniel; Spiera, Robert; Topilow, James; Treadwell, Edward L.; Vivino, Frederick B.; Volkmann, Elizabeth R.; Wallace, Daniel J.; Zashin, Scott; Argula, Rahul; Barney, Joseph B.; Burger, Charles D.; Downey, Gregory P.; Gagermeier, James; Helmers, Richard A.; Hewlett, J.C.; Keith, Rebecca C.; Koslow, Matthew; Kotloff, Robert M.; Krishna, R. Vijay; Luckhardt, Tracy; Robinson, Keith J.; Ryu, Jay H.; Shifren, Adrián; Staton, Gerald W.; Swigris, Jeff; Vassallo, Robert; Veraldi, Kristen L.; Ward, Robert W.; Bromet, Evelyn J.; Dale, Jeanne; Furlong, Judith A.; Neall, Kerry L.; Petruzzi, Lynn M.; Schäfer, Sarah; Kukla, Heidi

doi:10.1016/j.chest.2020.08.2117

Cited by 19 publications

(9 citation statements)

References 49 publications

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“…[49][50][51] Our finding that a lower proportion of respondents met the threshold for distress than in the RWBI instrument's validation cohort was unexpected. The observed prevalence was also lower than reported in other subspecialty fellows (50% of intensivist trainees screened positive for depression), 52 global residents/fellows (burnout range 39%-66%), 53 or health care workers in the COVID-19 pandemic (anxiety range 23.2%-44.6%; depression range 22.8%-50.4%). 9,10 The lower rate could be attributable to our survey frame, which comprised adult and pediatric fellows, the latter of whom have experienced lower volumes of patients with COVID-19 and demonstrated lower distress prevalence (13% versus 15% for adult fellows).…”

Section: Discussioncontrasting

confidence: 57%

“…An RWBI $5 correlates with a four-fold increased burnout risk, yet our observed proportion of distress (15%) was substantially lower than the 30% of nephrology fellows meeting the Maslach Burnout Inventory criteria in a prepandemic survey. 19,52,53 Although the RWBI is a composite measure of physician distress that correlates with burnout and other factors, it may not be a directly comparable to the Maslach Burnout Inventory or other assessments. 52,53 There were no significant associations between demographic variables and meeting the distress threshold.…”

Section: Discussionmentioning

confidence: 99%

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Impact of the COVID-19 Pandemic on Nephrology Fellow Training and Well-Being in the United States: A National Survey

Pivert

Boyle

Halbach

et al. 2021

JASN

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BackgroundThe coronavirus disease 2019 (COVID-19) pandemic’s effects on nephrology fellows’ educational experiences, preparedness for practice, and emotional wellbeing are unknown.MethodsWe recruited current adult and pediatric fellows and 2020 graduates of nephrology training programs in the United States to participate in a survey measuring COVID-19’s effects on their training experiences and wellbeing.ResultsOf 1005 nephrology fellows-in-training and recent graduates, 425 participated (response rate 42%). Telehealth was widely adopted (90% for some or all outpatient nephrology consults), as was remote learning (76% of conferences were exclusively online). Most respondents (64%) did not have in-person consults on COVID-19 inpatients; these patients were managed by telehealth visits (27%), by in-person visits with the attending faculty without fellows (29%), or by another approach (9%). A majority of fellows (84%) and graduates (82%) said their training programs successfully sustained their education during the pandemic, and most fellows (86%) and graduates (90%) perceived themselves as prepared for unsupervised practice. Although 42% indicated the pandemic had negatively affected their overall quality of life and 33% reported a poorer work-life balance, only 15% of 412 respondents who completed the Resident Well-Being Index met its distress threshold. Risk for distress was increased among respondents who perceived the pandemic had impaired their knowledge base (odds ratio [OR], 3.04; 95% confidence interval [CI], 2.00 to 4.77) or negatively affected their quality of life (OR, 3.47; 95% CI, 2.29 to 5.46) or work-life balance (OR, 3.16; 95% CI, 2.18 to 4.71).ConclusionsDespite major shifts in education modalities and patient care protocols precipitated by the COVID-19 pandemic, participants perceived their education and preparation for practice to be minimally affected.

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Section: Discussioncontrasting

confidence: 57%

Section: Discussionmentioning

confidence: 99%

Impact of the COVID-19 Pandemic on Nephrology Fellow Training and Well-Being in the United States: A National Survey

Pivert

Boyle

Halbach

et al. 2021

JASN

View full text Add to dashboard Cite

show abstract

“…Overall, this study by Sharp et al 9 should be a call to action for medical educators, hospital administrators, and institutions. It reveals the existence of burnout and depression within the pipeline of the pulmonary and critical care workforce and identifies systemic contributions that may heighten susceptibility to burnout.…”

mentioning

confidence: 91%

“…8 Among residents, work hour restrictions and resiliency training have been variably associated with improvements. This study 9 highlights that the appropriate interventions for fellows are not yet known.…”

mentioning

confidence: 93%

“…To address this gap, in this issue of CHEST, Sharp et al 9 performed a cross-sectional survey of Pulmonary, Critical Care, and combined Pulmonary-Critical Care fellows to assess for burnout, depression, and associated individual and institutional factors. Perhaps most importantly, they found that more than one-half of fellows experience either burnout or depression.…”

mentioning

confidence: 99%

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