L. C. Elmore1, D. B. Jeffe2, L. Jin1, M. M. Awad1, I. R. Turnbull1 1Washington University In St. Louis School Of Medicine,Surgery,Saint Louis, MISSOURI, USA 2Washington University In St. Louis School Of Medicine,Medicine,St. Louis, MO, USA
Introduction: Surgical residency is rigorous and burnout has emerged as a prevalent problem in trainees. Academic surgical programs provide trainees with a dedicated research experience distinct from their clinical training. The wellbeing of residents during this time and the impact of the interruption in clinical training on resident burnout is unknown. We report an analysis of burnout in research residents and a comparative analysis of burnout in residents who completed research during their surgical training and those who did not.
Methods: From April-December, 2014, an anonymous online survey was distributed to general surgery trainees via program directors. All ACGME-accredited programs were invited to participate. Demographic information, research history, program characteristics and professional goals were measured. Our primary endpoint was burnout, which was evaluated by the Maslach Burnout Inventory (MBI) and measured three aspects of burnout: emotional exhaustion (EE), depersonalization (DP) and personal accomplishment (PA). A score in the highest tertile for EE or DP and or the lowest tertile on PA were indicative of burnout. Tertiles were predetermined using Maslach’s normative scale previously validated in healthcare workers. Descriptive statistics were used to assess frequency distributions and chi-square tests were used to analyze categorical data.
Results: Of the 752 respondents, 88 (12%) were engaged in a dedicated research period at the time of survey. Of the remaining 664 clinical residents, 118 (17.8%) completed research during their residency training and 546 (82%) did not. Individuals who did not complete research had a higher rate of burnout than those who completed research during training and residents who were in the lab at the time of survey (70.1% vs. 61.0% vs. 59.1%, p=0.03). Residents who did not complete research were also more likely to score in the highest tertile for EE (59.5% vs 48.3% vs. 39.8%, p=0.004) and less likely to report high levels of personal accomplishment (42.5% vs. 54.2% vs. 64.8%, p<0.001) when compared to those who completed research during residency training and those who were currently in the lab. No significant differences were seen in rates of depersonalization. In order to compare the impact of research on residents in their terminal years of training, we evaluated burnout in clinical years four and five. There were no differences in overall rates of burnout or rates of EE and DP in residents who did research and those who did not; however, residents who did research were more likely to report high levels of personal accomplishment (57.5% vs. 42.5%, p=0.026).
Conclusion: Residents who have taken time away from residency for research or are actively engaged in research have lower rates of burnout than residents who have not completed research. This finding suggests that time for dedicated academic development and independent investigation may be protective against burnout.