An Evaluation of Burnout Among U.S. Rheumatology Fellows: A National Survey.

OBJECTIVE: To evaluate levels of burnout and correlates of burnout among U.S. rheumatology fellows.

METHODS: U.S. rheumatology fellows were invited to complete an electronic survey in 2019. Burnout was assessed utilizing Maslach Burnout Inventory (MBI). Measures of depression, fatigue, quality of life, and training year were also collected. Open-ended questions about perceived factors to promote resiliency and factors leading to increased burnout were included. Bivariate and multivariate regression analyses were used to examine correlates of burnout. Open-ended responses were analyzed using thematic analysis.

RESULTS: Response rate was 18.5% (105 of 567 pediatric and adult rheumatology fellows). Over one-third (38.5%) of PGY4 and 16.7% of PGY5/6 fellows reported at least one symptom of burnout. 12.8% of PGY4 fellows met criteria for depression compared with 2.4% of PGY5/6. PGY4 fellows reported worse fatigue and poorer quality of life compared with PGY5/6. In multivariable models controlling for training year and gender, older age (> 31) was associated with lower odds of burnout. Thematic analysis of openended responses identified factors that help reduce burnout: exercise, family/friends, sleep, support at work, and hobbies. Factors contributing to burnout: pager, documentation, long hours, and demands of patient care.

CONCLUSION: This national survey of U.S. rheumatology fellows reveals that early trainee level and younger age are associated with worse levels of fatigue, quality of life, and burnout. While awareness of and strategies to reduce burnout are needed for all fellows, targeted interventions for younger fellows and those in their first year of training may be of highest yield.