Elsevier

Academic Radiology

Volume 24, Issue 6, June 2017, Pages 682-693
Academic Radiology

Original Investigation
Emotional Wellness of Current Musculoskeletal Radiology Fellows

https://doi.org/10.1016/j.acra.2016.12.024Get rights and content

Rationale and Objectives

Burnout is a psychological syndrome composed of emotional exhaustion, depersonalization, and sense of lack of personal accomplishment, as a result of prolonged occupational stress. The purpose of our study was to determine the prevalence of burnout among current musculoskeletal radiology fellows and to explore causes of emotional stress.

Materials and Methods

A 24-item survey was constructed on SurveyMonkey using the Maslach Burnout Inventory. We identified 82 musculoskeletal radiology fellowship programs. We recruited subjects indirectly through the program director or equivalent.

Results

Fifty-eight respondents (48 male, 10 female) identified themselves as current musculoskeletal radiology fellows and completed the survey. Comparison of the weighted subscale means in our data to the Maslach normative subscale thresholds for medical occupations indicates that musculoskeletal radiology fellows report relatively high levels of burnout with regard to lack of personal accomplishment and depersonalization, whereas emotional exhaustion levels in our sample are within the average range reported by Maslach. Although male musculoskeletal radiology fellows experience relatively high levels in two of the three dimensions of burnout (depersonalization and personal accomplishment), female musculoskeletal radiology fellows experience relatively high burnout across all three dimensions. Job market-related stress and the effort required providing care for dependents significantly affect personal accomplishment. Conversely, imbalances in the work-life relationship and feelings of powerlessness are significantly associated with depersonalization and emotional exhaustion.

Conclusions

Musculoskeletal radiology fellows report relatively high levels of burnout. Because the consequences of burnout can be severe, early identification and appropriate intervention should be a priority.

Introduction

Burnout is a psychological syndrome occurring in human service workers and defined by Maslach along three dimensions: emotional exhaustion, depersonalization, and sense of lack of personal accomplishment (1). The syndrome is a result of prolonged occupational stress, in which an individual may become increasingly cynical, may become more callous toward those whom they are serving, and may grow increasingly dissatisfied with their accomplishments within the workplace 1, 2.

The field of radiology, as in every area of medicine in the United States, has undergone rapid changes in the past decade. Radiologists in both the private and academic sectors have been compelled to adapt to the implementation of the Affordable Care Act and accompanying legislation directed at healthcare reform (3). The resulting effects, such as consolidation in the provider and insurance markets and reduced reimbursement rates, have led to negative personal and work satisfaction for individual physicians (4).

In the ecology of radiologists in the United States, subspecialty fellows occupy a unique niche between residents and practicing academic physicians. We surmised that this intermediate position, subjecting them to the clinical responsibilities of academic practice but the transience, lower pay, and limited autonomy that come with a training position, coupled with the uncertainty of a job search, might result in high levels of burnout. If burnout is prevalent in high proportions, then preventing or ameliorating it in trainees should become an important focus of fellowship program directors.

The purpose of our study was to determine the current prevalence of burnout among musculoskeletal (MSK) radiology fellows, and to explore causes of stress that may contribute to burnout. We were also able to compare the prevalence of burnout and contributing stresses that MSK radiology fellows experience to that of MSK radiology faculty members. MSK radiology fellows were chosen as the specific study population because the authors are affiliated with an MSK radiology section and had access to this population; we did not have access to other populations of subspecialty fellows.

Section snippets

Human Subjects

This investigation of human subjects was granted exempt status from review by the University of Washington institutional review board.

Population and Sampling

We conducted a survey of current MSK radiology fellows. The survey instrument was created on SurveyMonkey (Professional) (5). MSK fellows are defined as individuals who have successfully completed a residency in diagnostic radiology and are currently engaged in a post-residency structured training program in MSK radiology. We identified 82 different MSK radiology

Results

The mean, standard deviation, and minimum and maximum scores for the variables used in our analyses are presented in Table 1, Panel A.

Why Does Burnout Matter?

According to Maslach et al, the burnout syndrome can lead to deterioration in the quality of care or service that is provided by staff, and can contribute to job turnover, absenteeism, and low morale (1). Additionally, burnout may lead to physical exhaustion, insomnia, increased use of alcohol and drugs, and marital and family problems (1).

Burnout among medical professionals has been linked to a lower degree of medical knowledge, the deterioration of professionalism, suboptimal patient care,

Conclusions

Radiology fellows have a high prevalence of burnout (88%). To prevent significant adverse outcomes of burnout, moretime and effort must be dedicated to the early recognition and intervention of the condition. To give optimal care to patients, a work environment that supports the well-being and mental health of its healthcare providers is essential.

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