Presentation Authors: Samuel Washington*, Kathryn Quanstrom, Peter Carroll, Kirsten Greene, San Francisco, CA
Introduction: Burnout, a syndrome of emotional exhaustion (EE), depersonalization (DP) and reduction in personal achievement (PA), has become an epidemic among physician in the United States, affecting up to 40-64% of practicing urologists. Physician burnout has the potential to significantly impact patient safety, reduce physician longevity, and may increase the risk of major medical errors. We aim to investigate the effect of program-level changes impact burnout in urology residents (PGY 2-6) and clinical faculty in the UCSF Department of Urology.
Methods: In this prospective, longitudinal survey-based cohort study, we used the validated Maslach Burnout survey to characterize in burnout at the start of the year and monitored scores at four-month intervals throughout the year. Burnout was defined as high scores in EE and DP. Program-level changes aimed at reducing stress/burnout were: 1) reduction of home call frequency across all hospitals, 2) creation of structured mentorship curriculum, and 3) didactics sessions moved from evenings to protected AM sessions.
Results: Our study cohort was comprised of 19 faculty and 15 residents (PGY2-6) Response rates were 74% for faculty and 93% for residents at the start of the study. At baseline, 21.4% of residents and 0 faculty reported burnout with response rates of . At 4 months, 28.6% of residents and 7.1% of faculty reported burnout. At 8 months, 28.6% of residents and 21.4% of faculty reported burnout. By 12 months, 14.3% of residents and 35.7% of faculty reported burnout. Burnout rates did not differ significantly between residents and faculty (p>0.05) at all timepoints although response rates declined to 50% by the end of the study.
Conclusions: Overall the observed levels of burnout were lower than previously reported but provides an opportunity for intervention. While a decline in burnout was not observed other program changes were anticipated or in place at the start of the study which may have limited the effect observed. Longer follow-up and increased sample sizes may be required to accurately estimate the impact of our interventions. Similarly, other departmental characteristics and practice patterns not directly measured in this study may have contributed to the low observed rates of burnout. Our findings illustrate an opportunity for implementation of resilience training and coping strategies in residency to help limit burnout throughout surgical training and clinical practice.
Source of Funding: 2017 Innovations Funding for Education grant by the UCSF Academy of Medical