Factors Associated with Burnout Among Minimally Invasive Gynecologic Surgery Fellows (FMIGS) in the Midst of COVID-19

STUDY OBJECTIVE: To assess burnout prevalence and associated factors among FMIGS fellows in the midst of COVID-19. DESIGN: Cross-sectional survey. SETTING: Online survey. PATIENTS OR PARTICIPANTS: FMIGS fellows, classes of 2021 and 2022. INTERVENTIONS: Anonymous survey including the validated Copenhagen Burnout Inventory (CBI). MEASUREMENTS AND MAIN RESULTS: 100 FMIGS fellows were invited to participate in the study. Of the 58 fellows with complete CBI survey data, 78% were 30-34 years old, 72% were female, 50% were first year, and 50% were second year fellows. The mean CBI score was 39.0 (SD=14.6), indicating moderate burnout. 22.4% of fellows had scores over 50, indicating high burnout. Personal and work-related burnout were highest, with CBI scores of 47.6 (SD=17.0) and 44.8 (SD=17.8), respectively. Patient related burnout scores were the lowest, at 23.6 (SD=16.7). With respect to the COVID-19 pandemic, 76% reported a decrease in surgical volume, 43% were assigned to roles outside their typical scope, and 28% experienced inadequate access to personal protective equipment. Factors associated with burnout included career choice dissatisfaction (Beta=6.3, 95% CI [1.7-10.9], p=0.009), and absence of a positive and respectful work environment (Beta=6.4, 95% CI [1.6-11.1], p=0.01). Fellows who were somewhat satisfied with their career choice scored 12.6 points higher than those who were highly satisfied. Fellows whose work environment was almost never positive and respectful scored 19.1 points higher than those whose work environment was always positive and respectful. Only one third reported regular individual wellness behaviors: mindfulness (24%), exercise (36%), sleep (31%), recreation (28%); however, these factors were not associated with burnout. CONCLUSION: In the midst of the COVID-19 pandemic, fellows had moderate to high personal and work-related burnout, while patient related burnout was low. Individual wellness behaviors were not associated with burnout, while the culture of the work environment was associated with burnout, highlighting the need to look beyond individual behavior in the fight against physician burnout.