We’re “re-blogging” the article below to prepare for our next AASChat taking place on Tuesday, March 31st at 8:00pm Eastern – please join your colleagues on Twitter for an important discussion on Discrimination, Harassment & Burnout in Surgical Residency Training. Our moderator for the Chat will be Dr. Yue-Yung Hu, MD MPH. Dr. Hu is a pediatric surgeon at Lurie Children’s Hospital of Chicago. She was an author for an article recently published in the New England Journal of Medicine entitled “Discrimination, Abuse, Harassment, and Burnout in Surgical Residency Training” – the summary of this article is below and the full article can be accessed HERE. This will be the basis of our #AASChat on Tuesday, and during our discussion, we’ll look at the following questions:
• What are some signs of trainee burnout that you have observed in your work environment?
• What strategies have you seen within your program or institution to combat trainee burnout?
• Do the types of discrimination and harassment reported in the article resonate with what you may have witnessed during your own training?
• What strategies have you developed at your organization to deal with reports of discrimination or harassment of trainees?
Discrimination, Abuse, Harassment, and Burnout in Surgical Residency Training
Yue?Yung Hu, M.D., M.P.H., Ryan J. Ellis, M.D., M.S.C.I., D. Brock Hewitt, M.D., M.P.H., Anthony D. Yang, M.D., Elaine Ooi Cheung, Ph.D., Judith T. Moskowitz, Ph.D., M.P.H., John R. Potts III, M.D., Jo Buyske, M.D., David B. Hoyt, M.D., Thomas J. Nasca, M.D., and Karl Y. Bilimoria, M.D., M.S.C.I
Article Summary: Burnout, a syndrome of emotional exhaustion, cynicism, and reduced effectiveness at work, has been linked to poor health, alcoholism, depression, and suicide in physicians. Burnout has adverse effects on patient care and the physician workforce since burned-out physicians are more likely to report that they have made medical errors, more frequently reduce their work efforts, change jobs, or leave the field of medicine. The prevalence of burnout appears to be higher among surgeons, trainees, and women than in other groups.
The values espoused by an institution and the social support it provides are key determinants of whether its employees feel engaged or burned out. Workplace mistreatment (i.e., discrimination, abuse, and harassment) can create a hostile work environment that may lead to burnout and other poor psychological outcomes, such as suicidality. Such mistreatment is thought to be common in the field of medicine, particularly for women and trainees, who are subject to a power differential. Surgery is considered to represent a particularly high-risk specialty.
Despite surgical residents’ particular vulnerability, little is known about the extent of mistreatment, burnout, and suicidal thoughts in this group. Previous estimates of mistreatment and burnout were based on surveys with low or unmeasurable response rates, small numbers of institutions, or inconsistencies in measurement or interpretation. Moreover, although an association between mistreatment and burnout has been suggested by qualitative data, it has yet to be examined empirically in a large population. A comprehensive national survey was administered to residents in all accredited U.S. general surgery residency programs to characterize the frequency and sources of mistreatment, examine the national prevalence of burnout and suicidal thoughts and assess the association of mistreatment with burnout and suicidal thoughts.
Yue-Yung Hu MD, MPH