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August 01, 2017; 89 (5) Article

Burnout, career satisfaction, and well-being among US neurology residents and fellows in 2016

Kerry H. Levin, Tait D. Shanafelt, Christopher M. Keran, Neil A. Busis, Laura A. Foster, Jennifer Rose V. Molano, Cormac A. O'Donovan, Jeffrey B. Ratliff, Heidi B. Schwarz, Jeff A. Sloan, Terrence L. Cascino
First published June 30, 2017, DOI: https://doi.org/10.1212/WNL.0000000000004135
Kerry H. Levin
From the Department of Neurology (K.H.L.), Cleveland Clinic, OH; Division of Hematology (T.D.S.), Division of Biomedical Statistics and Informatics (J.A.S.), and Department of Neurology (T.L.C.), Mayo Clinic, Rochester, MN; Member Insights Department (C.M.K.), American Academy of Neurology, Minneapolis, MN; Department of Neurology (N.A.B.), University of Pittsburgh School of Medicine, PA; Department of Neurology (L.A.F.), Brigham and Women's Hospital, Boston, MA; Department of Neurology and Rehabilitation Medicine (J.R.V.M.), University of Cincinnati College of Medicine, OH; Department of Neurology (C.A.O.), Wake Forest University, Winston-Salem, NC; Department of Neurology (J.B.R.), Thomas Jefferson University, Philadelphia, PA; and Department of Neurology (H.B.S.), University of Rochester School of Medicine and Dentistry, NY.
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Tait D. Shanafelt
From the Department of Neurology (K.H.L.), Cleveland Clinic, OH; Division of Hematology (T.D.S.), Division of Biomedical Statistics and Informatics (J.A.S.), and Department of Neurology (T.L.C.), Mayo Clinic, Rochester, MN; Member Insights Department (C.M.K.), American Academy of Neurology, Minneapolis, MN; Department of Neurology (N.A.B.), University of Pittsburgh School of Medicine, PA; Department of Neurology (L.A.F.), Brigham and Women's Hospital, Boston, MA; Department of Neurology and Rehabilitation Medicine (J.R.V.M.), University of Cincinnati College of Medicine, OH; Department of Neurology (C.A.O.), Wake Forest University, Winston-Salem, NC; Department of Neurology (J.B.R.), Thomas Jefferson University, Philadelphia, PA; and Department of Neurology (H.B.S.), University of Rochester School of Medicine and Dentistry, NY.
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Christopher M. Keran
From the Department of Neurology (K.H.L.), Cleveland Clinic, OH; Division of Hematology (T.D.S.), Division of Biomedical Statistics and Informatics (J.A.S.), and Department of Neurology (T.L.C.), Mayo Clinic, Rochester, MN; Member Insights Department (C.M.K.), American Academy of Neurology, Minneapolis, MN; Department of Neurology (N.A.B.), University of Pittsburgh School of Medicine, PA; Department of Neurology (L.A.F.), Brigham and Women's Hospital, Boston, MA; Department of Neurology and Rehabilitation Medicine (J.R.V.M.), University of Cincinnati College of Medicine, OH; Department of Neurology (C.A.O.), Wake Forest University, Winston-Salem, NC; Department of Neurology (J.B.R.), Thomas Jefferson University, Philadelphia, PA; and Department of Neurology (H.B.S.), University of Rochester School of Medicine and Dentistry, NY.
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Neil A. Busis
From the Department of Neurology (K.H.L.), Cleveland Clinic, OH; Division of Hematology (T.D.S.), Division of Biomedical Statistics and Informatics (J.A.S.), and Department of Neurology (T.L.C.), Mayo Clinic, Rochester, MN; Member Insights Department (C.M.K.), American Academy of Neurology, Minneapolis, MN; Department of Neurology (N.A.B.), University of Pittsburgh School of Medicine, PA; Department of Neurology (L.A.F.), Brigham and Women's Hospital, Boston, MA; Department of Neurology and Rehabilitation Medicine (J.R.V.M.), University of Cincinnati College of Medicine, OH; Department of Neurology (C.A.O.), Wake Forest University, Winston-Salem, NC; Department of Neurology (J.B.R.), Thomas Jefferson University, Philadelphia, PA; and Department of Neurology (H.B.S.), University of Rochester School of Medicine and Dentistry, NY.
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Laura A. Foster
From the Department of Neurology (K.H.L.), Cleveland Clinic, OH; Division of Hematology (T.D.S.), Division of Biomedical Statistics and Informatics (J.A.S.), and Department of Neurology (T.L.C.), Mayo Clinic, Rochester, MN; Member Insights Department (C.M.K.), American Academy of Neurology, Minneapolis, MN; Department of Neurology (N.A.B.), University of Pittsburgh School of Medicine, PA; Department of Neurology (L.A.F.), Brigham and Women's Hospital, Boston, MA; Department of Neurology and Rehabilitation Medicine (J.R.V.M.), University of Cincinnati College of Medicine, OH; Department of Neurology (C.A.O.), Wake Forest University, Winston-Salem, NC; Department of Neurology (J.B.R.), Thomas Jefferson University, Philadelphia, PA; and Department of Neurology (H.B.S.), University of Rochester School of Medicine and Dentistry, NY.
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Jennifer Rose V. Molano
From the Department of Neurology (K.H.L.), Cleveland Clinic, OH; Division of Hematology (T.D.S.), Division of Biomedical Statistics and Informatics (J.A.S.), and Department of Neurology (T.L.C.), Mayo Clinic, Rochester, MN; Member Insights Department (C.M.K.), American Academy of Neurology, Minneapolis, MN; Department of Neurology (N.A.B.), University of Pittsburgh School of Medicine, PA; Department of Neurology (L.A.F.), Brigham and Women's Hospital, Boston, MA; Department of Neurology and Rehabilitation Medicine (J.R.V.M.), University of Cincinnati College of Medicine, OH; Department of Neurology (C.A.O.), Wake Forest University, Winston-Salem, NC; Department of Neurology (J.B.R.), Thomas Jefferson University, Philadelphia, PA; and Department of Neurology (H.B.S.), University of Rochester School of Medicine and Dentistry, NY.
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Cormac A. O'Donovan
From the Department of Neurology (K.H.L.), Cleveland Clinic, OH; Division of Hematology (T.D.S.), Division of Biomedical Statistics and Informatics (J.A.S.), and Department of Neurology (T.L.C.), Mayo Clinic, Rochester, MN; Member Insights Department (C.M.K.), American Academy of Neurology, Minneapolis, MN; Department of Neurology (N.A.B.), University of Pittsburgh School of Medicine, PA; Department of Neurology (L.A.F.), Brigham and Women's Hospital, Boston, MA; Department of Neurology and Rehabilitation Medicine (J.R.V.M.), University of Cincinnati College of Medicine, OH; Department of Neurology (C.A.O.), Wake Forest University, Winston-Salem, NC; Department of Neurology (J.B.R.), Thomas Jefferson University, Philadelphia, PA; and Department of Neurology (H.B.S.), University of Rochester School of Medicine and Dentistry, NY.
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Jeffrey B. Ratliff
From the Department of Neurology (K.H.L.), Cleveland Clinic, OH; Division of Hematology (T.D.S.), Division of Biomedical Statistics and Informatics (J.A.S.), and Department of Neurology (T.L.C.), Mayo Clinic, Rochester, MN; Member Insights Department (C.M.K.), American Academy of Neurology, Minneapolis, MN; Department of Neurology (N.A.B.), University of Pittsburgh School of Medicine, PA; Department of Neurology (L.A.F.), Brigham and Women's Hospital, Boston, MA; Department of Neurology and Rehabilitation Medicine (J.R.V.M.), University of Cincinnati College of Medicine, OH; Department of Neurology (C.A.O.), Wake Forest University, Winston-Salem, NC; Department of Neurology (J.B.R.), Thomas Jefferson University, Philadelphia, PA; and Department of Neurology (H.B.S.), University of Rochester School of Medicine and Dentistry, NY.
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Heidi B. Schwarz
From the Department of Neurology (K.H.L.), Cleveland Clinic, OH; Division of Hematology (T.D.S.), Division of Biomedical Statistics and Informatics (J.A.S.), and Department of Neurology (T.L.C.), Mayo Clinic, Rochester, MN; Member Insights Department (C.M.K.), American Academy of Neurology, Minneapolis, MN; Department of Neurology (N.A.B.), University of Pittsburgh School of Medicine, PA; Department of Neurology (L.A.F.), Brigham and Women's Hospital, Boston, MA; Department of Neurology and Rehabilitation Medicine (J.R.V.M.), University of Cincinnati College of Medicine, OH; Department of Neurology (C.A.O.), Wake Forest University, Winston-Salem, NC; Department of Neurology (J.B.R.), Thomas Jefferson University, Philadelphia, PA; and Department of Neurology (H.B.S.), University of Rochester School of Medicine and Dentistry, NY.
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Jeff A. Sloan
From the Department of Neurology (K.H.L.), Cleveland Clinic, OH; Division of Hematology (T.D.S.), Division of Biomedical Statistics and Informatics (J.A.S.), and Department of Neurology (T.L.C.), Mayo Clinic, Rochester, MN; Member Insights Department (C.M.K.), American Academy of Neurology, Minneapolis, MN; Department of Neurology (N.A.B.), University of Pittsburgh School of Medicine, PA; Department of Neurology (L.A.F.), Brigham and Women's Hospital, Boston, MA; Department of Neurology and Rehabilitation Medicine (J.R.V.M.), University of Cincinnati College of Medicine, OH; Department of Neurology (C.A.O.), Wake Forest University, Winston-Salem, NC; Department of Neurology (J.B.R.), Thomas Jefferson University, Philadelphia, PA; and Department of Neurology (H.B.S.), University of Rochester School of Medicine and Dentistry, NY.
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Terrence L. Cascino
From the Department of Neurology (K.H.L.), Cleveland Clinic, OH; Division of Hematology (T.D.S.), Division of Biomedical Statistics and Informatics (J.A.S.), and Department of Neurology (T.L.C.), Mayo Clinic, Rochester, MN; Member Insights Department (C.M.K.), American Academy of Neurology, Minneapolis, MN; Department of Neurology (N.A.B.), University of Pittsburgh School of Medicine, PA; Department of Neurology (L.A.F.), Brigham and Women's Hospital, Boston, MA; Department of Neurology and Rehabilitation Medicine (J.R.V.M.), University of Cincinnati College of Medicine, OH; Department of Neurology (C.A.O.), Wake Forest University, Winston-Salem, NC; Department of Neurology (J.B.R.), Thomas Jefferson University, Philadelphia, PA; and Department of Neurology (H.B.S.), University of Rochester School of Medicine and Dentistry, NY.
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Citation
Burnout, career satisfaction, and well-being among US neurology residents and fellows in 2016
Kerry H. Levin, Tait D. Shanafelt, Christopher M. Keran, Neil A. Busis, Laura A. Foster, Jennifer Rose V. Molano, Cormac A. O'Donovan, Jeffrey B. Ratliff, Heidi B. Schwarz, Jeff A. Sloan, Terrence L. Cascino
Neurology Aug 2017, 89 (5) 492-501; DOI: 10.1212/WNL.0000000000004135

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Abstract

Objective: To study prevalence of and factors contributing to burnout, career satisfaction, and well-being in US neurology residents and fellows.

Methods: A total of 938 US American Academy of Neurology member neurology residents and fellows were surveyed using standardized measures of burnout, career satisfaction, and well-being from January 19 to March 21, 2016.

Results: Response rate was 37.7% (354/938); about 2/3 of responders were residents and 1/3 were fellows. Median age of participants was 32 years and 51.1% were female. Seventy-three percent of residents and 55% of fellows had at least one symptom of burnout, the difference largely related to higher scores for depersonalization among residents. For residents, greater satisfaction with work–life balance, meaning in work, and older age were associated with lower risk of burnout; for fellows, greater satisfaction with work–life balance and effective support staff were associated with lower risk of burnout. Trainees experiencing burnout were less likely to report career satisfaction. Career satisfaction was more likely among those reporting meaning in work and more likely for those working in the Midwest compared with the Northeast region.

Conclusions: Burnout is common in neurology residents and fellows. Lack of work–life balance and lack of meaning in work were associated with reduced career satisfaction and increased risk of burnout. These results should inform approaches to reduce burnout and promote career satisfaction and well-being in US neurology trainees.

GLOSSARY

AAN=
American Academy of Neurology;
ACGME=
Accreditation Council for Graduate Medical Education;
MBI-HSS=
Maslach Burnout Inventory–Human Services Survey;
QOL=
quality of life

Footnotes

  • Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Supplemental data at Neurology.org

  • Editorial, page 421

  • Received December 19, 2016.
  • Accepted in final form April 3, 2017.
  • © 2017 American Academy of Neurology
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Disputes & Debates: Rapid online correspondence

  • Author response to Dr. Sethi
    • Kerry H. Levin, Cleveland Cliniclevink@ccf.org
    • Shanafelt TD, Keran CM, Busis NA, Foster LA, Molano JRV, O'Donovan CA, Ratliff JB, Schwarz HB, Sloan JA, Cascino TL
    Submitted August 17, 2017
  • Burnout among residents and fellows: It is not all just work
    • Nitin K. Sethi, Associate Professor of Neurology, New York-Presbyterian Hospital, Weill Cornell Medical Center, New Yorksethinitinmd@hotmail.com
    Submitted August 15, 2017
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