Objective
To examine the prevalence of burnout among radiology trainees in the United States,
and to study the relationships between burnout and professional fulfillment (PF),
intent-to-leave (ITL), sleep-related impairment and self-compassion by gender.
Methods
This cross-sectional study was conducted via an anonymous electronic survey sent to
11 large academic medical centers (Physician Wellness Academic Consortium) between
January 2017 and September 2018. The survey included the Professional Fulfillment
Index (PFI) and an abbreviated form of the PROMIS Sleep-related impairment (SRI) scale.
Two-sample t-tests and chi-square exact tests were used for analysis (p < 0.05).
Results
Two hundred forty-seven radiology residents responded to the survey. Out of these,
36.2% reported burnout, 37.4% endorsed PF, 64.8% reported sleep-related impairment,
7.6% expressed ITL. There were no significant differences between genders. Burnout
was associated with reduced PF, increased sleep-impairment (p < 0.001 for both) and increased ITL (p = 0.02). Lower PF, peer support, perceived appreciation for and meaningfulness in
work, alignment of organizational and personal values, self-compassion, and higher
sleep impairment were associated with burnout (p < 0.001 for all). Burnout was associated with perceptions of less support from department
leaders (p = 0.003), control over schedules (p = 0.001) and helpfulness of electronic health record systems (p = 0.01). ITL was associated with reduced PF, perceived work appreciation, and leadership
support (p = 0.03, p = 0.04, and p = 0.007, respectively).
Discussion
Burnout is prevalent among radiology residents. Many demonstrate sleep-impairment
and reduced professional fulfillment, with a lesser fraction desiring to leave their
institution. Key factors to burnout included peer and organizational support, electronic
health record systems helpfulness, and personal factors like self-compassion and work
appreciation.
Key Words
Abbreviations:
PF (Professional fulfillment), ITL (Intention to leave), PFI (Professional fulfillment index), EE (Emotional exhaustion), DP (Depersonalization), PA (Personal accomplishment), EHR (Electronic health record), MBI (Maslach Burnout Inventory)To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Academic RadiologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Burnout and doctors: prevalence, prevention and intervention.Healthcare. 2016; 4: 37
- Job burnout.Annu Rev Psychol. 2001; 52: 397-422
- Maslach Burnout Inventory Manual.3 ed. Consulting Psychologists Press, Palo Alto, CA1996
- The well-being of physicians.Am J Med. 2003; 114: 513-519
- Changes in burnout and satisfaction with work-life balance in physicians and the general US working population between 2011 and 2014 [published correction appears in Mayo Clin Proc. 2016;91(2):276].Mayo Clin Proc. 2015; 90: 1600-1613
- Prevalence of alcohol use disorders among American surgeons.Arch Surg. 2012; 147: 168-174
- Special report: suicidal ideation among American surgeons.Arch Surg. 2011; 146: 54-62
- Marital and parental satisfaction of married physicians with children.J Gen Intern Med. 1999; 14: 157-165
- Burnout and medical errors among American surgeons.Ann Surg. 2010; 251: 995-1000
- Efficacy of a brief screening tool to identify medical students in distress.Acad Med. 2011; 86: 907-914
- The medical marriage: a national survey of the spouses/partners of US physicians.Mayo Clin Proc. 2013; 88: 216-225
- Work satisfaction of general practitioners and the quality of patient care.Fam Pract. 1985; 2: 128-135
- Physician wellness: a missing quality indicator.Lancet. 2009; 374: 1714-1721
- Physician burnout: a potential threat to successful health care reform.JAMA. 2011; 305: 2009-2010
- Academic faculty demonstrate higher well-being than residents: Pennsylvania anesthesiology programs’ results of the 2017-2018 ACGME well-being survey.J Clin Anesth. 2019; 56: 60-64
- The R.O.A.D. confirmed: ratings of specialties' lifestyles by fourth-year US medical students with a military service obligation.Fam Med. 2013; 45 (Apr): 240-246
- Mental health of hospital consultants: the effects of stress and satisfaction at work.Lancet. 1996; 347: 724-728
- Burnout and satisfaction with work-life balance among US physicians relative to the general US population.Arch Intern Med. 2012; 172: 1377-1385
- The emotional wellness of radiology trainees: prevalence and predictors of burnout.Acad Radiol. 2013; 20: 647-655
- Burnout: prevalence and associated factors among radiology residents in New England with Comparison against United States resident physicians in other specialties.AJR Am J Roentgenol. 2017; 209 (Jul): 136-141
- The STROBE guidelines.Saudi J Anaesth. 2019; 13 (Apr): S31-S34https://doi.org/10.4103/sja.SJA_543_18
- A brief instrument to assess both burnout and professional fulfillment in physicians: reliability and validity, including correlation with self-reported medical errors, in a sample of resident and practicing physicians.Acad Psychiatry. 2018; 42: 11-24
- Development of short forms from the PROMIS sleep disturbance and sleep-related Impairment item banks.Behav Sleep Med. 2011; 10: 6-24
- Narrative review on burnout experienced by medical students and residents.Med Educ. 2016; 50: 132-149
- Burnout among U.S. medical students, residents, and early career physicians relative to the general U.S. population.Acad Med. 2014; 89: 443-451
- Burnout in medical residents: a review.Med Educ. 2007; 41: 788-800
- Burnout in Canadian radiology residency: a national assessment of prevalence and underlying contributory factors.Can Assoc Radiol J. 2020; 71: 40-47
- Prevalence of burnout in medical and surgical residents: a meta-analysis.Int J Environ Res Public Health. 2019; 16: 1479https://doi.org/10.3390/ijerph16091479
- Stressors contributing to burnout amongst pediatric radiologists: results from a survey of the Society for Pediatric Radiology.Pediatr Radiol. 2019; 49: 714-722https://doi.org/10.1007/s00247-019-04370-z
- Well-being in residency: a systematic review.J Grad Med Educ. 2016; 8: 674-684https://doi.org/10.4300/jgme-d-15-00764.1
- The effects of sleep loss and fatigue on resident–physicians: a multi-institutional, mixed-method study.Acad Med. 2004; 79: 394-406https://doi.org/10.1097/00001888-200405000-00007
- JAMA Netw Open. 2020; 3 (et al 2020)e2028111https://doi.org/10.1001/jamanetworkopen.2020.28111
- The association between objectively-measured activity, sleep, call responsibilities, and burnout in a resident cohort.BMC Med Educ. 2019; 19https://doi.org/10.1186/s12909-019-1592-0
- Burnout's upside.J Am Coll Radiol. 2016; 13: 1538-1540https://doi.org/10.1016/j.jacr.2016.05.004
- Medscape Radiology Lifestyle Report 2016: Bias and Burnout.Medscape.com, 2020 (Published 2016. Accessed June 16)
- Professional fulfillment and intent-to-leave among ophthalmologists: a national study.Invest Ophthalmol Vis Sci. 2019; 60: 5492
- The relationship between perceived gender judgment and well-being among surgical residents.Am J Surg. 2018; 215: 233-237https://doi.org/10.1016/j.amjsurg.2017.08.049
- Emotional wellness of current musculoskeletal radiology fellows.Acad Radiol. 2017; 24: 682-693https://doi.org/10.1016/j.acra.2016.12.024
- Prevalence of burnout among pediatric radiologists.J Am Coll Radiol. 2019; 16: 518-522https://doi.org/10.1016/j.jacr.2018.08.016
- Work stress in radiologists. A pilot study.Radiol Med. 2008; 113https://doi.org/10.1007/s11547-008-0259-4
- Gender differences in utilization of duty-hour regulations, aspects of burnout, and psychological well-being among general surgery residents in the United States.Ann Surg. 2018; 268: 204-211https://doi.org/10.1097/sla.0000000000002700
- Addressing needs of women radiologists: opportunities for practice leaders to facilitate change.RadioGraphics. 2018; 38: 1626-1637https://doi.org/10.1148/rg.2018180023
- Burnout: job resources and job demands associated with low personal accomplishment in United States radiology residents.Acad Radiol. 2018; 25: 739-743https://doi.org/10.1016/j.acra.2017.12.002
- Factors associated with burnout among residents in a developing country.Ann Med Surg. 2016; 6: 60-63https://doi.org/10.1016/j.amsu.2016.01.090
- Burnout in academic radiologists in the United States.Acad Radiol. 2020; https://doi.org/10.1016/j.acra.2019.12.029
- The role of social support in burnout among Dutch medical residents.Psychol Health Med. 2007; 12: 1-6https://doi.org/10.1080/13548500600782214
- Baseline survey of the neuroradiology work environment in the United States with reported trends in clinical work, nonclinical work, perceptions of trainees, and burnout metrics.Am J Neuroradiol. 2017; 38: 1284-1291https://doi.org/10.3174/ajnr.a5215
- Burnout in chairs of academic radiology departments in the United States.Acad Radiol. 2019; 26: 1378-1384https://doi.org/10.1016/j.acra.2018.12.006
- Promoting well-being in radiology residency: a primer for program directors.Acad Radiol. 2020; 27: 720-723https://doi.org/10.1016/j.acra.2019.09.006
- Burnout phenomenon and its predictors in radiology residents.Acad Radiol. 2019; https://doi.org/10.1016/j.acra.2019.09.024
- Job stress and satisfaction among clinical radiologists.Clin Radiol. 2000; 55: 182-185https://doi.org/10.1053/crad.1999.0379
- Beyond substance abuse: stress, burnout, and depression as causes of physician impairment and disruptive behavior.J Am Coll Radiol. 2009; 6: 479-485https://doi.org/10.1016/j.jacr.2008.11.029
- Walk in my shoes’: intradepartmental role shadowing to increase workplace collegiality and wellness in a large pediatric radiology department.Pediatr Radiol. 2020; 50: 476-481https://doi.org/10.1007/s00247-019-04589-w
- Informatics solutions for driving an effective and efficient radiology practice.RadioGraphics. 2018; 38: 1810-1822https://doi.org/10.1148/rg.2018180037
- Scientific Paper Abstracts Presented at the Society of Abdominal Radiology 2017 Annual Scientific Meeting and Educational Course (March 26–31, 2017, Hollywood, Florida).Abdom Radiol. 2017; 42: 2005-2032https://doi.org/10.1007/s00261-017-1192-6
- Decreasing radiologist burnout through informatics-based solutions.Clin Imaging. 2020; 59: 167-171https://doi.org/10.1016/j.clinimag.2019.10.014
- The evolving role of the radiologist: the Vancouver Workload Utilization Evaluation Study.J Am Coll Radiol. 2013; 10: 764-769
- A human factors approach to understanding the types and sources of interruptions in radiology reading rooms.J Am Coll Radiol. 2016; 13: 1102-1105
- Do Mindfulness and self-compassion predict burnout in pediatric residents?.Acad Med. 2019; 94: 876-884https://doi.org/10.1097/acm.0000000000002546
- Mindfulness-based stress reduction for residents: a randomized controlled trial.J Gen Intern Med. 2017; 33: 429-436https://doi.org/10.1007/s11606-017-4249-x
- Controlled clinical trial comparing the effectiveness of a mindfulness and self-compassion 4-session programme versus an 8-session programme to reduce work stress and burnout in family and community medicine physicians and nurses: MINDUUDD study protocol.BMC Fam Pract. 2019; 20https://doi.org/10.1186/s12875-019-0913-z
- Stress Management and Resiliency Training (SMART) program among department of radiology faculty: a pilot randomized clinical trial.EXPLORE. 2014; 10: 358-363https://doi.org/10.1016/j.explore.2014.08.002
- Radiologist burnout according to surveyed radiology practice leaders.J Am Coll Radiol. 2020; 17: 78-81https://doi.org/10.1016/j.jacr.2019.07.008
- Etiology of burnout in canadian radiologists and trainees.Can Assoc Radiol J. 2020; (084653712090445)https://doi.org/10.1177/0846537120904452
- Why radiology residents experience burnout and how to fix it.Acad Radiol. 2019; 26: 555-558https://doi.org/10.1016/j.acra.2018.08.009
- Prevalence of burnout among musculoskeletal radiologists.Skeletal Radiol. 2017; 46: 497-506https://doi.org/10.1007/s00256-017-2578-9
- Describing the emotional exhaustion, depersonalization, and low personal accomplishment symptoms associated with Maslach Burnout Inventory subscale scores in US physicians: an item response theory analysis.J Patient Rep Outcomes. 2020; 4https://doi.org/10.1186/s41687-020-00204-x
Article info
Publication history
Published online: February 28, 2022
Accepted:
January 31,
2022
Received in revised form:
January 28,
2022
Received:
July 17,
2021
Identification
Copyright
© 2022 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.
