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Special Article
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Burnout and Emotional Well-Being among Nephrology Fellows: A National Online Survey

Varun Agrawal, Laura Plantinga, Khaled Abdel-Kader, Kurtis Pivert, Anthony Provenzano, Sandeep Soman, Michael J. Choi and Bernard G. Jaar
JASN April 2020, 31 (4) 675-685; DOI: https://doi.org/10.1681/ASN.2019070715
Varun Agrawal
1Division of Nephrology and Hypertension, University of Vermont, Burlington, Vermont;
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Laura Plantinga
2Department of Medicine, Emory University, Atlanta, Georgia;
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Khaled Abdel-Kader
3Division of Nephrology, Vanderbilt University Medical Center, Nashville, Tennessee;
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Kurtis Pivert
4Workforce, Training, and Career Advancement Department, American Society of Nephrology, Washington, DC;
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Anthony Provenzano
5Division of Nephrology, Duke University, Durham, North Carolina;
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Sandeep Soman
6Division of Nephrology and Hypertension, Henry Ford Hospital, Detroit, Michigan;
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Michael J. Choi
7Division of Nephrology and Hypertension, Medstar Georgetown University Hospital, Washington, DC;
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Bernard G. Jaar
8Department of Medicine, Division of Nephrology, Johns Hopkins University, Baltimore, Maryland;
9Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, Maryland; and
10Nephrology Center of Maryland, Baltimore, Maryland
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Abstract

Background Physician burnout and emotional distress are associated with work dissatisfaction and provision of suboptimal patient care. Little is known about burnout among nephrology fellows.

Methods Validated items on burnout, depressive symptoms, and well being were included in the American Society of Nephrology annual survey emailed to US nephrology fellows in May to June 2018. Burnout was defined as an affirmative response to two single-item questions of experiencing emotional exhaustion or depersonalization.

Results Responses from 347 of 808 eligible first- and second-year adult nephrology fellows were examined (response rate=42.9%). Most fellows were aged 30–34 years (56.8%), male (62.0%), married or partnered (72.6%), international medical graduates (62.5%), and pursuing a clinical nephrology fellowship (87.0%). Emotional exhaustion and depersonalization were reported by 28.0% and 14.4% of the fellows, respectively, with an overall burnout prevalence of 30.0%. Most fellows indicated having strong program leadership (75.2%), positive work-life balance (69.2%), presence of social support (89.3%), and career satisfaction (73.2%); 44.7% reported a disruptive work environment and 35.4% reported depressive symptoms. Multivariable logistic regression revealed a statistically significant association between female gender (odds ratio [OR], 1.90; 95% confidence interval [95% CI], 1.09 to 3.32), poor work-life balance (OR, 3.97; 95% CI, 2.22 to 7.07), or a disruptive work environment (OR, 2.63; 95% CI, 1.48 to 4.66) and burnout.

Conclusions About one third of US nephrology fellows surveyed reported experiencing burnout and depressive symptoms. Further exploration of burnout—especially that reported by female physicians, as well as burnout associated with poor work-life balance or a disruptive work environment—is warranted to develop targeted efforts that may enhance the educational experience and emotional well being of nephrology fellows.

  • burnout
  • graduate medical education
  • well-being
  • depression
  • fellowship
  • survey
  • Copyright © 2020 by the American Society of Nephrology
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Journal of the American Society of Nephrology: 31 (4)
Journal of the American Society of Nephrology
Vol. 31, Issue 4
April 2020
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Burnout and Emotional Well-Being among Nephrology Fellows: A National Online Survey
Varun Agrawal, Laura Plantinga, Khaled Abdel-Kader, Kurtis Pivert, Anthony Provenzano, Sandeep Soman, Michael J. Choi, Bernard G. Jaar
JASN Apr 2020, 31 (4) 675-685; DOI: 10.1681/ASN.2019070715

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Burnout and Emotional Well-Being among Nephrology Fellows: A National Online Survey
Varun Agrawal, Laura Plantinga, Khaled Abdel-Kader, Kurtis Pivert, Anthony Provenzano, Sandeep Soman, Michael J. Choi, Bernard G. Jaar
JASN Apr 2020, 31 (4) 675-685; DOI: 10.1681/ASN.2019070715
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