The Impact of Institutional Factors on Physician Burnout: A National Study of Urology Trainees

OBJECTIVE To determine the prevalence of burnout in urology trainees and examine the influence of personal, programmatic, and institutional factors on burnout rates. STUDY DESIGN We conducted an anonymous survey of burnout in urology residents across the United States using a 50-question REDCap-based electronic questionnaire in May of 2018. The survey included demographic questions, an inventory of stress-reduction techniques and the Maslach Burnout Inventory. Univariate analysis and multinomial logistic regression models were used to assess associations between individual, program, and organizational factors and resident burnout. RESULTS Overall response rate was 20.9%. Individual factors such as age, gender, exercise, and meditation were not associated with burnout while reading for relaxation (P = .022) and spending time with family (P = .025) were protective against burnout. Residents working >80 hours vs 60-80 hours and < 60 hours per week were more likely to exhibit burnout (77.6% vs 66.1% vs 47.1%, respectively, P = .044). Institutional factors such as structured mentorship programs (P = .019) and access to mental health services (P <. 001) were associated with decreased burnout. On multivariable analysis, unavailable or difficult-to-access mental health services were associated with increased odds of burnout (OR 5.38, 95% CI 2.20-13.16, P <. 001, and OR 2.33, 95% CI 1.07-5.07, P = .034, respectively). CONCLUSION The prevalence of burnout in urology trainees is high. Institutional factors such as formal mentorship and access to mental health services may play an important role in resident well-being. (C) 2019 Elsevier Inc.