There are numerous studies examining current trends and causes of physician burnout. The cause of burnout is multifactorial and has been linked to poor work-life balance, increased workload, higher rates of patient electronic medical record (EMR) messaging, and lack of ancillary support.¹ While this is not an exhaustive list, understanding what burnout is and who may be most susceptible is essential for prevention, as the downstream effects can touch all aspects of medicine. Indeed, physicians with burnout are more likely to make medical errors, have longer patient wait times, and demonstrate poor self-care.²

The overall physician burnout rate appears to be increasing nationally,¹ and this is no different in urology, with burnout rates reported as high as 36% to 70% in survey studies.^3-6 Most recently, Harris et al⁶ published data taken from the 2021 AUA annual census revealing that 36.7% of urologists reported burnout. The data also shed light on gender discrepancies between burnout rates, with women experiencing burnout at an increased rate of 14% compared to the census in 2016.⁶ Examining the numbers from the AUA census further will show that 43.7% of practicing urologists completed at least 1 fellowship and, in female pelvic medicine and reconstructive surgery (FPMRS), women represented 46.5% of the workforce.⁷

The literature examining burnout in urological subspecialties is limited. In the realm of FPMRS, Hudson et al⁸ surveyed 1039 active members of the American Urogynecologic Society with a response rate of only 280 (26.9%). Their data showed that 13% of responders fit the burnout profile, with significant differences seen for physicians who take call, have a current mentor, or have a feeling of control regarding their schedule. The authors go on to mention that survey data only reflect those who elected to answer, and poor response rates often plague even the largest studies. They further point out that the overall rate of burnout in FPMRS providers was significantly different depending on the definition utilized by studies, ranging from as low as 6.5% to as high as 51.9%.

Our data presented at the 2023 Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction Winter Meeting sought to expand on the literature on the FPMRS workforce and satisfaction. One hundred and eighteen urology-trained FPMRS physicians responded to our survey. The largest age group was 41 to 50 years, with the majority having been in practice for more than a decade. Over half of the respondents were women (Figures 1 and 2). Ninety-three percent of respondents stated they would still pursue an FPMRS fellowship after residency instead of general urology, and 40% perceived they are happier than their colleagues in other urologic subspecialties. Despite these findings, 44% of respondents stated they felt burnout—poor work-life balance and issues with the EMR were the most common reasons. The Table highlights the characteristics of their positions. The vast majority worked with advanced practitioners, had dedicated surgical schedulers, and spent most of their time performing clinical duties.

Table. Characteristics of Post-Training Position

Physician burnout remains a critical issue in the field of FPMRS and urology as a whole. Despite discussion and awareness, burnout rates in urology are increasing. Our study highlighted poor work-life balance and frustration with the EMR as key factors in dissatisfaction among physicians. While the data from these studies may not encompass the full spectrum of issues that play a role in physician burnout, there is a recurrent theme among the most common workplace dissatisfiers—something we can all be mindful of and, hopefully, benefit from.