The Prevalence of Faculty Physician Burnout in Military Graduate Medical Education Training Programs: A Cross-Sectional Study of Academic Physicians in the United States Department of Defense

Abstract

Introduction In military populations, physician burnout has potential to adversely affect medical readiness to deploy in support of joint operations. Burnout among Graduate Medical Education (GME) faculty may further threaten the welfare of the medical force given the central role these officers have in training and developing junior physicians. The primary aim of this investigation was to estimate the prevalence of burnout among faculty physicians in United States (US) Army, Navy, and Air Force GME programs. Materials and Methods We conducted a cross-sectional study of faculty physicians at US military GME training programs between January 2018 and July 2018. Through direct coordination with Designated Institutional Officials, we administered the Maslach Burnout Inventory Health Services Survey (MBI-HSS) via online web link to faculty physicians listed in Accreditation Data System at each sponsoring institution. In addition to the MBI-HSS, we collected demographic data and queried physicians about common occupational stressors in order to assist institutional leaders with identifying at-risk physicians and developing future interventions to address burnout. Results Sixteen of 21 institutions that currently sponsor military GME programs agreed to distribute the MBI-HSS survey to core faculty. We received completed assessments from 622 of the 1,769 (35.1%) reported physician core faculty at these institutions. Of the 622 physician respondents, 162 demonstrated high levels of emotional exhaustion and depersonalization for an estimated 26% prevalence of burnout. We identified only one independent risk factor for burnout: increasing numbers of deployments (OR 1.38, 95% CI 1.07–1.77). Physicians in our cohort who reported a desire to stay beyond their initial active duty service obligation were less likely to be classified with burnout (OR 0.45, 95% CI 0.26–0.77). The most common drivers of occupational distress were cumbersome bureaucratic tasks, insufficient administrative support, and overemphasis on productivity metrics. Conclusions We estimate that 26% of physician faculty in military GME programs are experiencing burnout. No specialty, branch of service, or specific demographic was immune to burnout in our sample. Institutional leaders in the MHS should take action to address physician burnout and consider using our prevalence estimate to assess effectiveness of future interventions.

Predictors of burnout among US healthcare providers: a systematic review

“…One of the studies of military providers found that staying beyond the initial active duty service obligation was a protective factor for burnout. 55 Among the seven prospective studies, six suggested that flexibility and clinical autonomy may protect providers against future burnout.…”

Burnout: Definition, Prevalence, Risk Factors, Prevention, and Interventions Literature Reviews

“…There is also some evidence suggesting that fewer physicians in academia experienced burnout than did physicians without an academic position (Gabbe et al, 2018;Porter et al, 2018;Summers et al, 2019).…”

“…The largest group of studies used versions of the MBI to assess burnout. The studies employing the MBI used a score of 27 or higher to represent a high level of EE, a score of ten or higher to represent a high level of DP, and a score of 33 or lower to represent a low level of PA (Attenello et al, 2018;Bundy et al, 2020;Busis et al, 2017;Fargen et al, 2019;Guenette and Smith, 2017;Hughes, Francis, and Sciscione, 2019;Lin et al, 2019;Levin et al, 2017;Marchalik, Brems, et al, 2019;Olson et al, 2019;Ramey et al, 2017;Shenoi et al, 2018;Summers et al, 2019). Of these, 32 studies defined burnout as having a high score on either the EE or the DP subscale of the MBI, including the full and the abbreviated versions.…”

“…One study measured burnout among behavioral health providers working in both military and community settings using the OLBI and reported an overall burnout rate of 23 percent (Stearns, Shoji, and Benight, 2018). One study examining burnout among faculty physicians in military graduate medical education programs reported a prevalence of 26 percent, defined by high EE and high DP on the MBI (Summers et al, 2019). Lastly, one study assessed burnout among medical staff deployed across Afghanistan and found that 33 percent of the staff experienced either high EE or high DP, measured with an abbreviated version of MBI (Adler et al, 2017).…”

Professional Burnout in Healthcare Workers: Signs, Causes, Prevention and Treatment

“…A high level of burnout among military doctors can be observed in the U.S. Army. The crossover study of burnout in medical teachers in servicemen training programs of the graduate medical education (GME) in the USA conducted by Summers SM, et al (2019) has shown that 26% of faculty members in military GME programs experience burnout. There were signifi cant variations in the prevalence of burnout depending on gender, speciality, institution, military rank, fi eld of service, and work experience.…”