Original contribution
Anesthesiology residency program director burnout

https://doi.org/10.1016/j.jclinane.2011.02.001Get rights and content

Abstract

Study Objective

To evaluate work-related stress as well as personal factors associated with professional burnout in program directors of anesthesiology.

Design

Survey instrument.

Setting

Academic anesthesiology department.

Subjects

Anesthesiology residency program directors (n = 132).

Measurements

A 5-part structured, open-ended questionnaire evaluating program and respondents' demographic information, work-related stressors, assessment of control of respondent's personal life using the modified efficiency scale, the Maslach Burnout Inventory-Human Services survey (MBI-HSS), and assessment of spousal/significant relationship support.

Main Results

100 program directors (76%) responded to the survey. Twenty respondents met the criteria for high burnout risk, and an additional 30 were at risk of developing burnout. Twenty-two directors reported the high likelihood that they would step down in one to two years. Forty-three percent who reported the high likelihood of stepping down stated they were significantly affected by job-related stressors compared with 18% who reported a lower likelihood of stepping down (P = 0.03). Program directors who scored in the high burnout risk category were more likely to report lower current job satisfaction (P < 0.005) and an increased likelihood of stepping down in the next two years (P = 0.009). Logistic regression analysis identified compliance issues, self-assessment of effectiveness, family/significant other support, perceived impact of stressful factors, and current job satisfaction as predictors of high burnout. The model had a sensitivity (95% CI) of 0.55 (0.34 to 0.74) and specificity of 0.99 (0.92 to 1.0) for predicting high burnout risk.

Conclusions

Fifty-two percent of anesthesiology program directors are at high risk for developing burnout syndrome. Job-related stress, especially with administrative duties regarding compliance, was predictive of burnout among program directors.

Introduction

Anesthesiology program directors are responsible for overseeing the successful training of the future generations of anesthesiologists. Among their professional responsibilities are the recruitment of new residents, development and supervision of an education curriculum, scheduling clinical coverage, and assurance of compliance guidelines from the Accreditation Council of Graduate Medical Education (ACGME) and specialty board requirements. In addition, they are frequently called on for guidance by the house staff and occasionally to address behavioral problems among residents.

Burnout is a work-related psychological syndrome characterized by emotional exhaustion, low personal accomplishment, and depersonalization [1]. Burnout differs from depression in that it is limited to the work environment; depression involves both professional and personal life. Clinical manifestations of burnout are commonly nonspecific and include fatigue, sleep and eating disorders, headache, and emotional instability. It is also associated with impaired job performance, and it may contribute to alcoholism and drug addiction [1]. The prevalence of burnout is higher among individuals whose job involves interactions with people, eg, physicians, nurses, and social workers [2]. Leadership burnout may not only affect the individual but the whole health care organization [3]. It is conceivable that program directors are at high risk of developing burnout as a result of the high amount of personal interaction involved in the demands of their job.

The objective of this study was to evaluate work-related stress as well as personal factors associated with professional burnout in anesthesiology program directors. We adapted a cross-sectional survey similar to one that we used to evaluate burnout in anesthesiology department chairpersons [4].

Section snippets

Materials and methods

The study was approved by the Institutional Review Board of Northwestern University. A cross-sectional nationwide survey was sent to 132 program directors in the United States. The distribution list was created using the 2009-2010 Directory of the American Medical Association section of Graduate Medical Education. The survey was created using SurveyMonkey software (SurveyMonkey Com LLC, Portland, OR, USA). To promote the confidentiality of the respondents, the survey was configured to delink

Results

One hundred program directors responded to the survey, 72 via the electronic version and 28 through the mail, corresponding to a response rate of 76%. Four surveys had insufficient response for adequate analysis of burnout. Distribution of characteristics of program directors and their positions are shown in Table 1. There was no difference in the median number of work hours by gender (P = 0.41) or duration of appointment (P = 0.27). The median number of residents in programs in which program

Discussion

The important finding of this study is the high incidence of burnout (21%) among anesthesiology program directors in the United States. When considering the program directors who are at high risk for developing the syndrome (defined by a Maslach score of moderate-high burnout), the number reaches 52%. Program directors of anesthesiology constantly deal with the challenges of running an educational program, including processing frequent changes in compliance and requirements of the ACGME, and

References (22)

  • GabbeSG et al.

    Burnout in chairs of obstetrics and gynecology: diagnosis, treatment and prevention

    Am J Obstet Gynecol

    (2002)
  • AndersonKD et al.

    Feeling the stress: perceptions of burnout among general surgery program directors

    Curr Surg

    (2000)
  • Maslach C, Leiter MP. Maslach Burnout Inventory Manual, 3rd ed. Palo Alto (CA): Consulting Psychologists Press, Inc.;...
  • FeltonJS

    Burnout as a clinical entity–its importance in health care workers

    Occup Med (Lond)

    (1998)
  • BroffmanG

    Controlled burn! Physician executives must be ready to handle job burnout, career stress

    Physician Exec

    (2001)
  • De OlivieraGS et al.

    High incidence of burnout in academic chairs of anesthesiology: should we be taking better care of our leaders?

    Anesthesiology

    (2011)
  • CareyMP et al.

    Reliability and validity of the appraisal of diabetes scale

    J Behav Med

    (1991)
  • SpanierGB

    Measuring dyadic adjustment: new scales for assessing the quality of marriage and similar dyads

    J Marriage Fam

    (1976)
  • PearlinLI et al.

    The structure of coping

    J Health Soc Behav

    (1978)
  • PenkowerL et al.

    Husbands' layoff and wives' mental health. A prospective analysis

    Arch Gen Psychiatry

    (1988)
  • PhelanJ et al.

    Work stress, family stress and depression in professional and managerial employees

    Psychol Med

    (1991)
  • Cited by (63)

    • Burnout in Cardiac Anesthesiologists: Results From a National Survey in Italy

      2018, Journal of Cardiothoracic and Vascular Anesthesia
    • Identifying Managerial Roles of General Surgery Coordinators: Making the Case for Utilization of a Standardized Job Description Framework

      2018, Journal of Surgical Education
      Citation Excerpt :

      As a result of the Outcome Project and NAS, administrative burdens increased for program directors as they are required to respond to frequent changes in compliance and requirements of the ACGME, as well as other challenges in running an education program. With these burdens, the residency coordinator position has inherently morphed from a clerical, coordinator of tasks to a manager of people, policies, and competency outcomes.2,5,6 The roles of both faculty and program directors in terms of teaching, evaluating, and directing the residency and fellowship program have been recognized and formally specified in the ACGME CPR.

    View all citing articles on Scopus

    Financial Support: Department of Anesthesiology, Northwestern University.

    View full text