Introduction: Physician burnout starts early in training, disproportionately impacts women and those URM, and is detrimental personally and professionally. Recent data suggest burnout continues to be a growing problem in graduate medical education (GME), but is mainly specialty or institution specific. Our purpose is to describe the current prevalence and risk factors for burnout amongst female physician trainees across multiple institutions and specialties. Methods: A multi-institutional randomized controlled trial involving 26 GME programs across America began in September 2022 to investigate the effectiveness of a professional coaching program. Baseline demographics and the Trauma Symptoms of Discrimination Scale (TSDS) of 1,017 volunteer female trainees were collected. The TSDS is a 21-item self-report measure focusing on trauma symptoms surrounding the experience of discrimination. All participants completed baseline surveys including the Maslach Burnout Inventory (MBI). Burnout was defined as scoring >27 for emotional exhaustion (EE) and/or >10 for depersonalization (DP). Multivariable logistic regression identified socio-demographic and/or professional covariates associated with burnout. Results: All 1,017 trainees responded to the baseline survey. 207 were PGY-1, 198 were PGY-2, and 596 were PGY-3 and beyond, with 19% identifying as surgical trainees. Participants on average had high EE (m = 30.58) and high DP (m = 11.83). DP was more often present in higher PGYs (PGY2: OR 2.61, 95% Confidence Interval [CI] 1.52-4.52, p<0.001; >=PGY3: OR 2.33, 95% CI 1.45-3.78, p<0.001). Higher scores on the TSDS positively correlated with overall burnout (Odds Ratio [OR] 1.30 for 10 units of change, 95% CI 1.11-1.53, p=0.001), EE (OR 1.26 for 10 units of change, 95% CI 1.11-1.43, p<0.001), and DP (OR 1.12 for 10 units of change, 95% CI 1.00-1.26, p=0.058). Conclusions: Results from this large, multi-institutional cohort show ongoing and progressive burnout prevalence throughout medical training. There is also an association between discrimination-based trauma and burnout in trainees, which has been shown recently in practicing attending physicians as well. Interestingly, we found that EE seems to peak in PGY2 year, while DP increases with PGY level. Smaller studies have shown PGY2 as a burnout peak as well and may highlight a dark point in the GME training hierarchy, with more junior trainees being responsible for tedious tasks whilst taking more call and documentation burden. Future studies should explore interventions in trainee burnout, specifically in those who have experienced trauma from discrimination. SOURCE OF Funding: None
