9. BURNOUT IN PEDIATRIC HEMATOLOGY ONCOLOGY FELLOWS, CROSS-SECTIONAL EXTENT AND OUTCOMES

Abstract

Background Burnout is plaguing doctors at all levels with severe consequences. Despite high emotional intensity, burnout rates among pediatric hematology-oncology (PHO) faculty have been less than previously described (Roth, PBC, 2011). The landscape of burnout among PHO fellows remains unknown. Objectives Describe the prevalence, determinants, and associated outcomes of burnout among PHO fellows. Methods 115 PHO fellows enrolled in a humanism curriculum study were administered the Maslach burnout inventory, empowerment at work scale, patient-provider orientation scale (PPOS), and satisfaction in training scale. Secondary analyses were performed using chi square analysis for demographic risk factors, and t-test for the continuous outcome variables. Results A total of 45/115 fellows (39.1%) met criteria for high level of burnout. No demographic variables were identified as statistically significant risk factors to predict high levels of burnout, including year of fellowship. The prevalence of high-level burnout among 2nd and 3rd year fellows was not significantly lower than that of 1st year fellows (36% vs 46%, p=0.3), revealing burnout to be an issue across the full fellowship experience. Program size was not significantly associated with level of burnout, though there was a trend towards large programs contributing a higher proportion of fellows with high levels of burnout (62.2% of fellows with high burnout trained in large programs vs 47.1% of those without high burnout). Those who met criteria for high burnout were associated with poor outcomes (Table 1). Conclusions This study identified more than 1/3 of current PHO trainees experiencing high levels of burnout. Interestingly, research years may not be as protective as thought and those at larger programs might be at higher risk, though more data are required. High level burnout is associated with decreased satisfaction with training, poor empowerment, and less patient-centered care. These data beg the need for longitudinal investigation of burnout in PHO fellows, both for their own well-being but also for the possible impact on patient care.