Abstract
Objective: Burnout and suicidality are known risks for vascular surgeons above other surgical subspecialties, with surgical trainees at risk for exposure to factors that increase burnout. This study aimed to inform initiatives to improve wellness by assessing the prevalence of hazards in vascular training (mistreatment, duty-hour violations) and the rates of wellness outcomes (burnout, thoughts of attrition/specialty change/suicide). We hypothesized that mistreatment and duty-hour violations would predispose trainees to increased burnout. Methods: We performed a cross-sectional study of residents and fellows enrolled in accredited United States vascular surgery training programs using a voluntary, confidential survey administered during the 2020 Vascular Surgery In-Training Examination. The primary outcome assessed was burnout symptoms reported on a weekly basis or more frequently. The rates of wellness outcomes were measured. The association of mistreatment and duty hours with the primary outcome was modeled with multivariable logistic regression. Results: A total of 475 residents and fellows who were enrolled in one of 120 vascular surgery training programs completed the survey (84.2% response rate). Of 408 trainees completing burnout survey items, 182 (44.6%) reported symptoms of burnout. Fewer trainees reported thoughts of attrition (n = 42 [10.0%], specialty change (n = 35 [8.4%]), or suicide (n = 22 [4.9%]). Mistreatment was reported by 191 vascular trainees (47.3%) and was more common in female trainees (n = 63 [48.5%] reporting monthly or more frequently) compared with male trainees (n = 51 [18.6%]; P <.001). Duty-hour violations were also more commonly reported by female trainees (n = 31 [21.4%] reporting 3+ months in violation) compared with male trainees (n = 50 [16.2%]; P =.002). After controlling for race/ethnicity, postgraduate year, program type, and geography, female trainees were less likely to report burnout (odds ratio [OR], 0.49; 95% confidence interval [CI], 0.28-0.86). Trainees experiencing mistreatment monthly or more were three times more likely to report burnout (OR, 3.09; 95% CI, 1.78-5.39). Frequency of duty-hour violations also increased the odds of reporting burnout (1-2 months in violation: OR, 2.09; 95% CI, 1.17-3.73; 3+ months in violation: OR, 3.95; 95% CI, 2.24-6.97). Conclusions: Nearly one-half of vascular surgery trainees reported symptoms of burnout, which was associated with frequency of mistreatment and duty-hour violations. Interventions to improve well-being in vascular surgery must be tailored to the local training environment to address trainee experiences that contribute to burnout.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 308-315.e4 |
| Journal | Journal of Vascular Surgery |
| Volume | 75 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 2022 |
Funding
Author conflict of interest: Y.-Y.H. and K.Y.B. report grants from the American College of Surgeons and Accreditation Council for Graduate Medical Education during the conduct of the study. M.C.C. and R.D.L. report grants from the National Heart, Lung, and Blood Institute of the National Institutes of Health under grant numbers T32HL094293-12 . The authors have no other conflicts of interest to disclose. This study was supported by the American College of Surgeons, the Accreditation Council for Graduate Medical Education, and the National Heart, Lung, and Blood Institute of the National Institutes of Health. The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication. The results and conclusions of this article are the authors' own and do not represent the opinions of the Accreditation Council for Graduate Medical Education, the American College of Surgeons, the National Heart, Lung, and Blood Institute, or the National Institutes of Health.Author conflict of interest: Y.-Y.H. and K.Y.B. report grants from the American College of Surgeons and Accreditation Council for Graduate Medical Education during the conduct of the study. M.C.C. and R.D.L. report grants from the National Heart, Lung, and Blood Institute of the National Institutes of Health under grant numbers T32HL094293-12. The authors have no other conflicts of interest to disclose. This study was supported by the American College of Surgeons , the Accreditation Council for Graduate Medical Education , and the National Heart, Lung, and Blood Institute of the National Institutes of Health . The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication. The results and conclusions of this article are the authors' own and do not represent the opinions of the Accreditation Council for Graduate Medical Education, the American College of Surgeons, the National Heart, Lung, and Blood Institute, or the National Institutes of Health.
Keywords
- Burnout
- Internship and residency
- Medical education
- Wellness
ASJC Scopus subject areas
- Surgery
- Cardiology and Cardiovascular Medicine
