APGO

Amber N. Watters, MD
McGaw Medical Center of Northwestern University, Chicago, IL

Primary objective: To determine whether an interventional wellness program ameliorates or prevents burnout among residents in obstetrics and gynecology.

Secondary objectives: 1) To increase awareness of the concept of burnout among resident physicians. 2) To increase awareness of the wide range of wellness behaviors and techniques.

Methods: A twelve month, single institution prospective interventional study was designed. The study population included first through fourth year obstetrics and gynecology residents, and each resident served as his/her own control. Resident burnout and overall well-being was assessed using the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) and the Center for Epidemiologic Studies – Depression Scale (CES-D). Both instruments were administered at enrollment, six months into the study period, and at the conclusion of the study (July 2012, January 2013, and July 2013) to all participating residents. The intervention consisted of a thirty minute educational session each month, administered to each resident level independently in a small group format. The thirty minute sessions comprised a wellness curriculum, ranging in topics from communication to mindfulness to self-care.

Results: We received responses on the CES-D and MBI from 24 residents in total (53%). Six residents provided data at one time point, six residents provided data at two time points, and twelve residents provided data for all three study time points. The CES-D revealed clinically significant depression (scores > 16) at the time of assessment in 7 different residents over the course of the study (29% of residents were depressed at some point during the academic year). Of the residents who provided data for two or three time points, CES-D scores demonstrated considerable fluctuations without significant trends toward improvement in or worsening of depression despite the wellness intervention. The MBI revealed burnout (deficits in 2/3 subcategories) in 10 residents (42%) during at least one of the data collection points (2 residents had burnout at all 3 collection points and 2 residents had burnout at 2 of the collection points). Similarly, emotional exhaustion (MBI subset score > 27) was present in 9 residents and depersonalization (MBI subset score >10) in 14 residents. However, only 3 residents had a low sense of personal accomplishment (MBI subset score <33) at any time. For the residents who provided data for both time points, MBI scores again demonstrated fluctuations without significant trends toward improvement in or worsening of burnout despite the wellness intervention.

Conclusions: We have re-demonstrated that obstetrics and gynecology residents have significant rates of depression and burnout, although our rates were lower than many in the literature. We were unable to demonstrate amelioration or prevention of resident depression or burnout with our wellness curriculum.

Key words: Resident Burnout, Wellness Training