Burnout in Pediatric Nephrology Fellows and Faculty: Lessons From the Sustainable Pediatric Nephrology Workforce Project (SUPERPOWER)

Susan M Halbach; Kartik Pillutla; Patricia Seo-Mayer; Alan Schwartz; Darcy Weidemann; John D Mahan

doi:10.3389/fped.2022.849370

Burnout in Pediatric Nephrology Fellows and Faculty: Lessons From the Sustainable Pediatric Nephrology Workforce Project (SUPERPOWER)

Front Pediatr. 2022 May 4:10:849370. doi: 10.3389/fped.2022.849370. eCollection 2022.

Authors

Susan M Halbach^{1

2}, Kartik Pillutla³, Patricia Seo-Mayer⁴, Alan Schwartz^{5

6}, Darcy Weidemann^{7

8}, John D Mahan⁹

Affiliations

¹ Division of Nephrology, Seattle Children's Hospital, Seattle, WA, United States.
² Department of Pediatrics, University of Washington, Seattle, WA, United States.
³ Department of Pediatrics, University of Texas Dell Medical School, Austin, TX, United States.
⁴ Division of Nephrology, Inova Children's Hospital, Falls Church, VA, United States.
⁵ Department of Medical Education and Department of Pediatrics, University of Illinois at Chicago, Chicago, IL, United States.
⁶ Association of Pediatric Program Directors, McLean, VA, United States.
⁷ Division of Nephrology, Children's Mercy Kansas City, Kansas City, MO, United States.
⁸ Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, MO, United States.
⁹ Division of Nephrology and Hypertension, Nationwide Children's Hospital, The Ohio State University, Columbus, OH, United States.

Abstract

Physician well-being is an important contributor to both job satisfaction and patient outcomes. Rates of burnout among physicians vary by specialty, ranging from 35 to 70%. Among pediatric residents, longitudinal data demonstrates consistent rates of burnout around 50-60%, although little is known about burnout among pediatric subspecialty fellows. Specifically, the degree of burnout among pediatric nephrologists remains unknown, as does the impact faculty burnout may have on trainee burnout. We sought to evaluate prevalence and predictors of burnout among US pediatric nephrology fellows and faculty, and assess for interactions between groups. In this multi-center pilot survey of all United States pediatric nephrology training programs from February to April 2020, burnout was assessed through abbreviated Maslach Burnout Inventory and predictors were explored through survey items devoted to demographic, personal characteristics, and job and career satisfaction questions. A total of 30/34 available fellows and 86/102 faculty from 11 institutions completed the survey (overall response rate 85%). The prevalence of burnout was 13% among fellows and 16% among faculty. Demographic (age, gender, year of training, faculty rank, marital status) and program factors (fellowship size, faculty size, current block/rotation, vacation or weekend off timing) were not significantly associated with burnout. Faculty and fellows with burnout reported significantly lower quality of life (5.3 vs. 7.9, p < 0.05), higher perceived stress (2.4 vs. 1.4, p < 0.05) and lower satisfaction with career choice (66 vs. 22%) and work life balance (28 vs. 0%), compared to those without burnout (p < 0.05 for all). Other important factors positively associated with burnout included lower institutional support for wellness programs and lower satisfaction with both colleague and faculty support. Larger studies are needed to explore if burnout is truly less prevalent among pediatric nephrology fellows and faculty compared to pediatric residents and graduate physicians. A larger sample size is also necessary to determine whether any interactions exist between the faculty and trainee roles in the developments of burnout. Future studies should also explore how to promote well-being through addressing key factors such as overall learning/working environment, stress reduction, and building personal resilience.

Keywords: burnout; faculty; fellow; pediatric nephrology; workforce.