Prevalence and Etiology of Burnout in a Community-Based Graduate Medical Education System: A Mixed-Methods Study.

BACKGROUND AND OBJECTIVES: Burnout rates among American physicians and trainees are high. The objectives of this study were: (1) to compare burnout rates among residents and faculty members of the graduate medical education (GME) programs sponsored by the University of Kansas School of Medicine-Wichita (KUSM-W) to previously published data, and (2) to evaluate the physicians' feedback on perceived causes and activities to promote wellness.

METHODS: Between April and May 2017, we surveyed 439 residents and core faculty members from 13 residency programs sponsored by the KUSM-W. The survey included the Abbreviated Maslach Burnout Inventory, two open-ended questions, and demographic questions. The authors used Kruskal-Wallis and Fisher exact tests to analyze the quantitative data, and an immersion-crystallization approach to analyze the open-ended data.

RESULTS: Forty-three percent of all respondents met the criteria for burnout, and the overall response rate was 50%. When compared with core faculty members, rates of burnout among residents were higher (51% vs 31%, P<.05). The immersion-crystallization approach revealed five interconnected themes as possible causes of burnout among physicians: work-life imbalance, system issues, poor morale, difficult patient populations, and unrealistic expectations. Promotion of healthy and mindfulness activities; enhanced program leadership; and administration, program, and system modification were identified as activities/resources that can promote wellness among physicians.

CONCLUSIONS: The findings show that burnout is prevalent among physicians within GME. Wellness and burnout prevention should be addressed at the beginning of medical training and longitudinally. Potential intervention should include activities that allow physicians to thrive in the health care environment.