Skip to main content

The Burden of Leadership: a Survey of Burnout Experiences Among Psychiatry Program Directors

Abstract

Objective

The objectives of this study were to examine the prevalence of burnout, specify contributors to and protective factors against burnout, and gather suggestions to improve well-being in psychiatry Program Directors.

Methods

A survey regarding burnout and wellness was distributed to psychiatric Program Directors through the email listserv of the American Association of Directors of Psychiatric Residency Training (AADPRT).

Results

The survey response rate was 273 responses out of 880 members surveyed (31%). The majority of respondents were current residency or fellowship Program Directors or Associate Program Directors or had another current educational role (93%, 227/245). Almost half of current Program Directors or Associate Program Directors reported feeling burned out almost daily or once a week (44%, 93/210). These Program Directors reported a desire to resign (77%), experienced discrimination within the past 5 years (66%), and struggled with finding meaning in their job (44%). The most frequently endorsed contributors to burnout were increasing administrative burden and insufficient support.

Conclusions

The survey findings confirm that burnout characteristics are common among respondents, associated with a desire to resign and a struggle to find meaning in the highly demanding position of Program Director or Associate Program Director. Advocacy for resources, decreased administrative overload, and increased protected time would enhance well-being in Program Directors. Most striking was the frequency of discrimination reported and its relationship to burnout. Departments may benefit from a careful review of policies, procedures, and training to decrease hostile workplaces for women, international medical graduate, and under-represented in medicine Program Directors.

This is a preview of subscription content, access via your institution.

References

  1. Green DE, Walkey FH, Taylor AJ. The three-factor structure of the Maslach Burnout Inventory: a multicultural, multinational confirmatory study. J Soc Behav Personal. 1991;6(3):453–72.

    Google Scholar 

  2. Dyrbye LN, Thomas MR, Massie FS Jr, Power DV, Eacker A, Harper W, et al. Burnout and suicidal ideation among U.S. medical students. Ann Intern Med. 2008;149(5):334–41.

    Article  Google Scholar 

  3. West CP, Shanafelt TD, Kolars JC. Quality of life, burnout, educational debt, and medical knowledge among internal medicine residents. JAMA. 2011;306(9):952–60.

    CAS  Article  Google Scholar 

  4. Shanafelt TD, Balch CM, Bechamps GJ, Russell T, Dyrbye L, Satele D, Collicott P, Novotny PJ, Sloan J, Freischlag JA. Burnout and career satisfaction among American surgeons. Ann Surg. 2009;250(3):463–71.

    Article  Google Scholar 

  5. Shanafelt TD, Boone S, Tan L, Dyrbye L, Sotile W, Satele D, et al. Burnout and satisfaction with work-life balance among US physicians relative to the general US population. Arch Intern Med. 2012;172(18):1377–85.

    Article  Google Scholar 

  6. Shanafelt TD, Hasan O, Dyrbye LN, Sinsky C, Satele D, Sloan J, West CP. Changes in burnout and satisfaction with work-life balance in physicians and the general US working population between 2011 and 2014. Mayo Clin Proc. 2015;90(12):1600–13.

    Article  Google Scholar 

  7. Accreditation Council for Graduate Medical Education (ACGME). ACGME Common Program Requirements (Residency) [Internet]. 2020 Accessed at https://www.acgme.org/Portals/0/PFAssets/ProgramRequirements/CPRResidency2020.pdf. Accessed 1 April 2021.

  8. Nfonoyim B, Martin A, Ellison A, Wright JL, Johnson TJ. Experiences of underrepresented faculty in pediatric emergency medicine. Acad Emerg Med. 2021;28(9):982–92.

    Article  Google Scholar 

  9. Kemper KJ, Schwartz A. on behalf of the Pediatric Resident Burnout-Resilience Study Consortium. Bullying, discrimination, sexual harassment, and physical violence: common and associated with burnout in pediatric residents. Acad Pediatr. 2020;20(7):991–7.

    Article  Google Scholar 

  10. Hu YY, Ellis RJ, Hewitt DB, Yang AD, Cheung EO, Moskowitz JT, Potts JR III, Buyske J, Hoyt DB, Nasca TJ, Bilimoria KY. Discrimination, abuse, harassment, and burnout in surgical residency training. N Engl J Med. 2019;381(18):1741–52.

    Article  Google Scholar 

  11. O'Connor AB, Halvorsen AJ, Cmar JM, Finn KM, Fletcher KE, Kearns L, McDonald FS, Swenson SL, Wahi-Gururaj S, West CP, Willett LL. Internal medicine residency program director burnout and program director turnover: results of a national survey. Am J Med. 2019;132(2):252–61.

    Article  Google Scholar 

  12. De Oliveira Jr GS, Almeida MD, Ahmad S, Fitzgerald PC, McCarthy RJ. Anesthesiology residency program director burnout. J Clin Anesth. 2011;23(3):176–82.

    Article  Google Scholar 

  13. Porter M, Hagan H, Klassen R, Yang Y, Seehusen DA, Carek PJ. Burnout and resiliency among family medicine program directors. Fam Med. 2018;50(2):106–12.

    Article  Google Scholar 

  14. West CP, Dyrbye LN, Sloan JA, Shanafelt TD. Single item measures of emotional exhaustion and depersonalization are useful for assessing burnout in medical professionals. J Gen Intern Med. 2009;24(12):1318–21.

    Article  Google Scholar 

  15. Shim RS. Dismantling structural racism in academic medicine: a skeptical optimism. Acad Med. 2020;95(12):1793–5.

    Article  Google Scholar 

  16. Dyrbye L, Herrin J, West CP, Wittlin NM, Dovidio JF, Hardeman R, Burke SE, Phelan S, Onyeador IN, Cunningham B, van Ryn M. Association of racial bias with burnout among resident physicians. JAMA Netw Open. 2019;2(7):e197457.

    Article  Google Scholar 

Download references

Acknowledgements

This work is a product of an American Association of Directors of Psychiatric Residency Training Burnout Task Force inaugurated by Adam Brenner, MD, Past-President.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Donna M. Sudak.

Ethics declarations

Ethics Approval

This study was approved by the University of Virginia Institutional Review Board for Social and Behavioral Sciences

Disclosures

De Golia — Book Royalties: American Psychiatric Press; Leadership Role: American Association of Directors of Psychiatric Residency Training–Steering Committee; Sudak — Book Royalties: Wolters-Kluwer, Wiley, American Psychiatric Press; Leadership role: American Association of Directors of Psychiatric Residency Training–Steering Committee, ACGME Review Committee for Psychiatry; Welton — American Association of Directors of Psychiatric Residency Training–Steering Committee; Zalpuri — support for travel- Stanford Department of Psychiatry and Behavioral Sciences.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

De Golia, S.G., Houston, L.J., Madaan, V. et al. The Burden of Leadership: a Survey of Burnout Experiences Among Psychiatry Program Directors. Acad Psychiatry (2022). https://doi.org/10.1007/s40596-022-01675-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s40596-022-01675-4

Keywords

  • Burnout
  • Meaning
  • Administrative burden
  • Discrimination