Rationale and Objectives
Burnout is a complex phenomenon characterized by emotional exhaustion, social detachment, and feelings of low personal achievement. In this study, we aim to establish the prevalence of burnout among radiology trainees and to explore the factors influencing its development.
Materials and Methods
Survey data were collected from 266 trainee members of the Association of University Radiologists to assess financial status, attitudes toward money and compensation, and burnout symptomology. Descriptive and inferential statistics were used to analyze these data.
Results
Most radiology residents reported high levels of personal achievement but routine symptoms of emotional exhaustion and depersonalization. Although increasing levels of household debt were correlated with symptoms of depersonalization and lower reported quality of life, we found that the subjective financial experience was a more reliable indicator of emotional well-being. Specifically, higher subjective self-assessments of financial strain were the best predictors of symptoms of depersonalization ( P < .0001), emotional exhaustion ( P < .0001), and lower self-reported quality of life ( P < .0001). Additionally, residents with recent moonlighting activity reported higher levels of personal achievement ( P < .05), lower levels of emotional exhaustion ( P < .05), and greater quality of life ( P < .05) when compared to non-moonlighters.
Conclusions
The unique nature of radiology training could mean that traditional assumptions regarding the development of trainee burnout do not necessarily apply. Finances may be an underappreciated influence on resident burnout, and subjective feelings of financial scarcity could outweigh the impact of objective indebtedness. Further study is needed to ensure that the emotional well-being of radiology trainees is optimally supported.
Burnout is a psychological syndrome, arising in response to prolonged occupational stress, which is characterized by emotional depletion, pathologic detachment, and feelings of personal inadequacy. The negative impact of work-related stress on resident physicians and their performance in the clinical setting is well established , but currently there are no studies examining the prevalence of burnout symptoms among radiology residents . Financial instability has been shown to be a principal stressor for resident physicians . However, there remains a paucity of evidence regarding the specific influence of financial strain on burnout among medical trainees . The purpose of this study is to explore the prevalence of burnout symptoms among radiologists in training and to explore the factors influencing its development.
Methods
This investigation was exempted from full review by the University of Washington institutional review board. In January 2012, an electronic survey was distributed to all resident and fellow junior members of the Association of University Radiologists with registered e-mail addresses (1389 members). The survey questions are reproduced in the Appendix . A 4-week reminder e-mail was sent and responses gathered for a total of 8 weeks.
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Results
Survey Sample Demographics
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Household Finances
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Residency-Related Finances
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Table 1
Resident Perceptions of Work-related Departmental Subsidies
Benefit No Subsidy ∗ Inadequate Subsidy Adequate Subsidy Full Subsidy Books, educational materials 38 (14) 130 (49) 81 (30) 17 (6) Medical license, DEA certification 143 (54) 39 (15) 21 (8) 63 (24) ABR dues/fees 152 (57) 45 (17) 24 (9) 45 (17) AIRP expenses 14 (5) 136 (51) 69 (26) 47 (18)
ABR, American Board of Radiology; AIRP, American Institute for Radiologic Pathology; DEA, Drug Enforcement Administration.
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Perceived Financial Strain
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Table 2
Resident Responses to Questions Regarding Financial Strain
Statement Strongly Disagree ∗ Disagree Somewhat Disagree Neutral Somewhat Agree Agree Strongly Agree My current financial situation is a serious strain. 21 (7.9) 34 (12.8) 25 (9.4) 39 (14.7) 49 (18.4) 58 (21.8) 40 (15.0) I often think about my current financial situation. 12 (4.5) 15 (5.6) 8 (3.0) 16 (6.0) 45 (16.9) 74 (27.8) 96 (36.1) Due to my financial situation, I have difficulties paying for mandatory work-related expenses (eg, American Board of Radiology dues, licensing) 37 (13.9) 49 (18.4) 28 (10.5) 40 (15.0) 42 (15.8) 38 (14.3) 32 (12.0) Due to my financial situation, I have difficulties purchasing optional work-related expenses (eg, textbooks) 26 (9.8) 51 (19.2) 20 (7.5) 30 (11.3) 48 (18.0) 43 (16.2) 48 (18.0) Due to my financial situation, I have difficulties paying for my apartment and utilities. 44 (16.5) 74 (27.8) 40 (15.0) 41 (15.4) 31 (11.7) 16 (6.0) 20 (7.5) Due to my financial situation, I am restricted in my leisure activities. 17 (6.4) 24 (9.0) 20 (7.5) 21 (7.9) 53 (19.9) 51 (19.2) 80 (30.1)
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Burnout Symptoms in Radiology Trainees
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Burnout Symptoms and Financial Strain
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Comparison of Burnout Prevalence among Radiology Trainees versus Internal Medicine Residents
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Table 3
Comparison of Burnout Symptoms and Quality of Life between Radiology Trainees and Internal Medicine Residents
Wellness Factor Trainee Responses Emotional exhaustion (EE) High ∗ Low Radiology 142 (53) 124 (47) Internal medicine 7394 (46) 8760 (54) Depersonalization (DP) High Low Radiology 131 (49) 135 (51) Internal medicine 4541 (29) 11,196 (71) High EE or DP Yes No Radiology 165 (62) 101 (38) Internal medicine 8343 (52) 7849 (48) Quality of life Low Not low Radiology 30 (11) 236 (89) Internal medicine 2402 (15) 13,785 (85)
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Discussion
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Conclusions
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Appendix
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