Burnout and Emotional Well-Being among Nephrology Fellows: A National Online Survey

Abstract

BackgroundPhysician burnout and emotional distress are associated with work dissatisfaction and provision of suboptimal patient care. Little is known about burnout among nephrology fellows.MethodsValidated items on burnout, depressive symptoms, and well being were included in the American Society of Nephrology annual survey emailed to US nephrology fellows in May to June 2018. Burnout was defined as an affirmative response to two single-item questions of experiencing emotional exhaustion or depersonalization.ResultsResponses from 347 of 808 eligible first- and second-year adult nephrology fellows were examined (response rate=42.9%). Most fellows were aged 30–34 years (56.8%), male (62.0%), married or partnered (72.6%), international medical graduates (62.5%), and pursuing a clinical nephrology fellowship (87.0%). Emotional exhaustion and depersonalization were reported by 28.0% and 14.4% of the fellows, respectively, with an overall burnout prevalence of 30.0%. Most fellows indicated having strong program leadership (75.2%), positive work-life balance (69.2%), presence of social support (89.3%), and career satisfaction (73.2%); 44.7% reported a disruptive work environment and 35.4% reported depressive symptoms. Multivariable logistic regression revealed a statistically significant association between female gender (odds ratio [OR], 1.90; 95% confidence interval [95% CI], 1.09 to 3.32), poor work-life balance (OR, 3.97; 95% CI, 2.22 to 7.07), or a disruptive work environment (OR, 2.63; 95% CI, 1.48 to 4.66) and burnout.ConclusionsAbout one third of US nephrology fellows surveyed reported experiencing burnout and depressive symptoms. Further exploration of burnout—especially that reported by female physicians, as well as burnout associated with poor work-life balance or a disruptive work environment—is warranted to develop targeted efforts that may enhance the educational experience and emotional well being of nephrology fellows.

“To Be, or Not to Be” a Nephrologist: Students’ Dilemma and a Strategy for the Field

“…A relatively high degree of overall career satisfaction among nephrologists has also been reported by other recent studies [9,[13][14][15]. By assuming the key influence of role models in the career selection, which is true not only for nephrology [16], the satisfaction of nephrology practitioners may be pivotal for attracting interest to the specialty among medical students.…”

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

“…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.…”

Lessons Learned: Nephrology Training Program Adaptation in the Time of COVID

“…The COVID-19 pandemic has forced a checkpoint for fellow wellbeing, and has provided opportunities to prioritize interventions to address burnout within our field. 15 , 16 The pandemic has incentivized many programs to develop more tools to assess and monitor fellow wellness. These initiatives align with the ACGME requirements for the inclusion of wellbeing initiatives in the learning and workforce environment.…”