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JU INSIGHT Burnout in Urological Education: An In-Depth Study of Residents and Fellows in the 2021 AUA Census

By: Andrew M. Harris, MD, University of Kentucky Medical Center, Lexington, Lexington VA Medical Center, Kentucky; Roei Golan, MD, Florida State University College of Medicine, Tallahassee; Kate Kraft, MD, University of Michigan, Ann Arbor; Amanda North, MD, Montefiore Medical Center, Bronx, New York; Parth Modi, MD, University of Chicago, Illinois; William Meeks, MA, University of Kentucky Medical Center, Lexington, Lexington VA Medical Center, Kentucky; Emily Galen, BS, University of Kentucky Medical Center, Lexington, Lexington VA Medical Center, Kentucky; Alexis Helsel, PhD, MPH, University of Kentucky Medical Center, Lexington, Lexington VA Medical Center, Kentucky, American Urological Association, Linthicum, Maryland; Kevin Koo, MD, Mayo Clinic, Rochester, Minnesota | Posted on: 17 Jul 2024

Harris AM, Golan R, Kraft K, et al. Burnout in urological education: An in-depth study of residents and fellows in the 2021 AUA census. J Urol. 2024;212(1):205-212. doi:10.1097/JU.0000000000003949

Study Need and Importance

Professional burnout among urologists has been a growing concern since the early 2010s, with studies revealing a stable overall burnout rate. The condition, characterized by exhaustion, diminished personal accomplishment, and depersonalization, poses significant risks to physicians’ well-being and patient care quality. Previous research primarily focused on practicing physicians, overlooking residents and fellows who represent the future of the urological workforce and are particularly vulnerable to burnout. Addressing burnout in this group is critical, especially given its association with depression and suicidality.

What We Found

The 2021 AUA Census included responses from 243 urology trainees, revealing a burnout rate of 48% among residents and 33% among fellows. Burnout was linked to various factors, including training level, lack of access to urology-specific call rooms, and difficulty attending personal health appointments (Figure). Additionally, 53% of trainees considered changing their career or specialty choice at some point. Burnout was inversely linked to having children during residency. Desired benefits and resources highlighted included meal plans, health appointment accessibility, and paid family leave.

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Figure. Various factors contributing to burnout. PGY indicates postgraduate year.

Limitations

The study’s limitations include a low response rate (10%) among AUA residents and fellows members, potentially limiting the generalizability of the findings. The risk of type I error is likely due to the large number of questions answered.

Interpretation for Patient Care

Burnout among urology residents and fellows is a pressing issue with serious implications for patient care and the well-being of the medical workforce. It’s crucial to identify its multifaceted causes, including personal, institutional, and systemic issues. Using tools like the Maslach Burnout Inventory aids in recognizing residents facing burnout and uncovering triggers for targeted interventions. Enhanced screening methods and discussions about specific concerns, such as scheduling or support policies, are critical. Broader strategies include mentorship, stress reduction programs, and promoting mental health services. Ensuring the well-being of urology trainees is essential for sustaining a competent and compassionate urological workforce.

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