A National Longitudinal Study of Wellness Curricula in US Family Medicine Residency Programs and Association With Early Career Physician Burnout.

Abstract

Background Physician burnout during residency training and practice is rising, yet it is unclear how residency workload preparation or wellness curricula affect postgraduate burnout. Objective To determine whether US family medicine residency wellness curricula or workload metrics are associated with self-reported burnout 3 years after graduation. Methods Graduate self-reported burnout was assessed as a single-item measure-either "feeling burned out" (for emotional exhaustion) or "callousness" (for depersonalization) or both once a week or more-on the 2021 National Graduate Survey (NGS). These data were paired with responses to a 2018 Council of Academic Family Medicine Education Research Alliance (CERA) Program Director survey that assessed residency workload and the wellness curricula when the graduate was a third-year resident. Bivariate and multivariate analyses, including graduate practice factors and demographics, were conducted against the burnout measures. Results The dataset included 738 of 1623 (45.5%) graduates who responded to the 2021 NGS (or 738 of 3596, 20.5% of the entire 2021 NGS cohort) from 202 of 587 (34.4%) family medicine residencies. Forty percent of graduate respondents reported burnout. In bivariate analyses, higher burnout among graduates was associated with presence of non-facilitated small groups (43.7% vs 35.8% with burnout, P=.04), whereas lower burnout was seen with stress management curricula (63.8% without burnout vs 55.9%, P=.03), and lower work hours in postgraduate year (PGY) 1 (65.7% vs 57.4% without burnout, P=.05). In multivariate analyses only, work hours as a PGY-1 was associated with lower burnout, (OR=1.5; 95% CI, 1.04-2.31; P=.03). Conclusions Controlling for family medicine residency practice factors and graduate demographics, in this national longitudinal study there was no association of burnout 3 years following graduation with the presence or type of wellness curricula as measured in the graduating year of residency, though working less than 60 hours a week during PGY-1 remained associated with lower burnout.