Burnout looms larger for third-year residents

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Radiology residents experience heightened depersonalization throughout most of their training, yet they may face their toughest battle against burnout in their third year, according to research in the May issue of the Journal of the American College of Radiology.

In a survey of first- through fourth-year residents, researchers explored relationships between known factors that cause burnout and year of training among radiology residents. They found third-year residents had higher emotional exhaustion and depersonalization scores and lower personal accomplishment scores than their peers in other years.

"As trainees progress through residency, their responsibilities increase. This, along with the timing of board examinations, may contribute to fluctuating burnout symptoms during training," stated first author Dr. Brian Sifrig of University of Florida Health in Jacksonville.

The results warrant further investigation of the relationship between subcomponents of burnout and year of training among radiology trainees, Sifrig and colleagues wrote.

Approximately 35% to 54% of nurses and physicians and 45% to 60% of medical students and residents experience symptoms of burnout, according to the National Academy of Medicine. Radiology is among specialties with reported burnout rates as high as 46%.

Burnout is characterized by high emotional exhaustion, high depersonalization, and a low sense of personal accomplishment from work and has been shown to have major personal, organizational, and societal impacts on patient care and patient safety.

In this study, Sifrig et al sought to investigate the relationship between these subcomponents of burnout and year of training among radiology residents. They surveyed 2,823 radiology trainees and asked them to complete a validated MBI Human Services Survey, which measures emotional exhaustion with a score between 0 and 54, depersonalization from 0 to 30. Personal accomplishment is measured with a score between 0 and 48, with a lower score indicating greater potential for burnout.

A total of 770 of 2,823 residents (27.3%) responded, with 488 of 770 completing the survey. The researchers found a statistically significant difference in scores between cohorts based on year of training and a statistically significant effect between year of training and emotional exhaustion and depersonalization, but not personal accomplishment.

Third-year residents reported a higher frequency of emotional exhaustion than first-year residents and a higher frequency of depersonalization than first-year and second-year residents. Fourth-year residents reported more depersonalization than first-year residents.

The authors offered the following major points to characterize the potential for burnout among radiology residents:

  • Residents are emotionally exhausted at least once a month on average, depersonalized at least a few times a year, and feel personally accomplished at least once a week, but not daily.
  • Third-year residents recorded the highest average scores for emotional exhaustion and depersonalization and the lowest score for personal accomplishment.
  • Although the means between the emotional exhaustion and personal accomplishment scales appear to be similar between matriculating and graduating radiology residents, the mean depersonalization scale remains statistically higher and may not return to baseline during or even after training.

While their findings demonstrate evidence of burnout among residents, the authors noted that the mean subcomponent scores for emotional exhaustion and depersonalization were lower and personal achievement was higher in fact for all trainees than seen in previous studies assessing radiology residents.

"The discordant results from available research and lack of published literature regarding burnout among radiology residents warrants further investigation between the relationship of the subcomponents of burnout and year of training among radiology trainees," they concluded.

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