title: Taking Care of Our Own: A Multispecialty Study of Resident and Program Director Perspectives on Contributors to Burnout and Potential Interventions.
abstract: OBJECTIVE
  Rates of resident physician burnout range from 60 to 76 % and are rising. Consequently, there is an urgent need for academic medical centers to develop system-wide initiatives to combat burnout in physicians. Academic psychiatrists who advocate for or treat residents should be familiar with the scope of the problem and the contributors to burnout and potential interventions to mitigate it. We aimed to measure burnout in residents across a range of specialties and to describe resident- and program director-identified contributors and interventions.
  
  
  METHODS
  Residents across all specialties at a tertiary academic hospital completed surveys to assess symptoms of burnout and depression using the Maslach Burnout Inventory and the Patient Health Questionnaire-9, respectively. Residents and program directors identified contributors to burnout and interventions that might mitigate its risk. Residents were asked to identify barriers to treatment.
  
  
  RESULTS
  There were 307 residents (response rate of 61 %) who completed at least one question on the survey; however, all residents did not respond to all questions, resulting in varying denominators across survey questions. In total, 190 of 276 residents (69 %) met criteria for burnout and 45 of 263 (17 %) screened positive for depression. Program directors underestimated rates of burnout, with only one program director estimating a rate of 50 % or higher. Overall residents and program directors agreed that lack of work-life balance and feeling unappreciated were major contributors. Forty-two percent of residents reported that inability to take time off from work was a significant barrier to seeking help, and 25 % incorrectly believed that burnout is a reportable condition to the medical board.
  
  
  CONCLUSIONS
  Resident distress is common and most likely due to work-life imbalance and feeling unappreciated. However, residents are reluctant to seek help. Interventions that address work-life balance and increase access to support are urgently needed in academic medical centers.
authors.affiliation: University of North Carolina, Chapel Hill, NC, USA. emily.holmes@unchealth.unc.edu.
authors.forename: Emily G
authors.initials: EG
authors.lastname: Holmes
authors.affiliation: University of North Carolina, Chapel Hill, NC, USA.
authors.forename: AnnaMarie
authors.initials: A
authors.lastname: Connolly
authors.affiliation: University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Karen T
authors.initials: KT
authors.lastname: Putnam
authors.affiliation: University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Kenan M
authors.initials: KM
authors.lastname: Penaskovic
authors.affiliation: University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Clark R
authors.initials: CR
authors.lastname: Denniston
authors.affiliation: University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Leslie H
authors.initials: LH
authors.lastname: Clark
authors.affiliation: University of North Carolina, Chapel Hill, NC, USA.
authors.forename: David R
authors.initials: DR
authors.lastname: Rubinow
authors.affiliation: University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Samantha
authors.initials: S
authors.lastname: Meltzer-Brody
mesh_terms: D000328:Adult; D002055:Burnout, Professional / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000706:statistics & numerical data*; D008297:Male; D010820:Physicians / Q000706:statistics & numerical data*
keywords: Burnout; Depression; Medical education; Residency