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Burnout and Distress Among Internal Medicine Program Directors: Results of A National Survey

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Abstract

BACKGROUND

Physician burnout and distress has been described in national studies of practicing physicians, internal medicine (IM) residents, IM clerkship directors, and medical school deans. However, no comparable national data exist for IM residency program directors.

OBJECTIVE

To assess burnout and distress among IM residency program directors, and to evaluate relationships of distress with personal and program characteristics and perceptions regarding implementation and consequences of Accreditation Council for Graduate Medical Education (ACGME) regulations.

DESIGN AND PARTICIPANTS

The 2010 Association of Program Directors in Internal Medicine (APDIM) Annual Survey, developed by the APDIM Survey Committee, was sent in August 2010 to the 377 program directors with APDIM membership, representing 99.0 % of the 381 United States categorical IM residency programs.

MAIN MEASURES

The 2010 APDIM Annual Survey included validated items on well-being and distress, including questions addressing quality of life, satisfaction with work-life balance, and burnout. Questions addressing personal and program characteristics and perceptions regarding implementation and consequences of ACGME regulations were also included.

KEY RESULTS

Of 377 eligible program directors, 282 (74.8 %) completed surveys. Among respondents, 12.4 % and 28.8 % rated their quality of life and satisfaction with work-life balance negatively, respectively. Also, 27.0 % reported emotional exhaustion, 10.4 % reported depersonalization, and 28.7 % reported overall burnout. These rates were lower than those reported previously in national studies of medical students, IM residents, practicing physicians, IM clerkship directors, and medical school deans. Aspects of distress were more common among younger program directors, women, and those reporting greater weekly work hours. Work–home conflicts were common and associated with all domains of distress, especially if not resolved in a manner effectively balancing work and home responsibilities. Associations with program characteristics such as program size and American Board of Internal Medicine (ABIM) pass rates were not found apart from higher rates of depersonalization among directors of community-based programs (23.5 % vs. 8.6 %, p = 0.01). We did not observe any consistent associations between distress and perceptions of implementation and consequences of program regulations.

CONCLUSIONS

The well-being of IM program directors across domains, including quality of life, satisfaction with work-life balance, and burnout, appears generally superior to that of medical trainees, practicing physicians, and other medical educators nationally. Additionally, it is reassuring that program directors' perceptions of their ability to respond to current regulatory requirements are not adversely associated with distress. However, the increased distress levels among younger program directors, women, and those at community-based training programs reported in this study are important concerns worthy of further study.

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Acknowledgements

We are grateful for the support of APDIM, the members of the APDIM Survey Committee, and the residency program directors who completed the APDIM survey. The Mayo Clinic Survey Research Center provided assistance with the survey design and data collection. This study was supported in part by the Mayo Clinic Internal Medicine Residency Office of Educational Innovations as part of the ACGME Educational Innovations Project. This paper does not constitute an official policy statement of APDIM, the APDIM Council, or any other organization with which any of the authors may be affiliated.

Conflict of Interest

The authors declare that they do not have a conflict of interest.

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Authors and Affiliations

  1. Division of General Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, USA

    Colin P. West MD, PhD & Furman S. McDonald MD, MPH

  2. Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA

    Colin P. West MD, PhD

  3. Internal Medicine Residency Office of Educational Innovations, Department of Medicine, Mayo Clinic, Rochester, MN, USA

    Andrew J. Halvorsen MS

  4. California Pacific Medical Center, San Francisco, CA, USA

    Sara L. Swenson MD

  5. Division of General Internal Medicine, Department of Medicine and Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, 55905, USA

    Colin P. West MD, PhD

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  1. Colin P. West MD, PhD
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  2. Andrew J. Halvorsen MS
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  3. Sara L. Swenson MD
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  4. Furman S. McDonald MD, MPH
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Correspondence to Colin P. West MD, PhD.

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West, C.P., Halvorsen, A.J., Swenson, S.L. et al. Burnout and Distress Among Internal Medicine Program Directors: Results of A National Survey. J GEN INTERN MED 28, 1056–1063 (2013). https://doi.org/10.1007/s11606-013-2349-9

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