Resident Burnout After the 2011 Accreditation Council for Graduate Medical Education Duty-Hour Restrictions

Abstract

INTRODUCTION: In 2011, the Accreditation Council for Graduate Medical Education implemented work restrictions for interns (Postgraduate Year [PGY] 1) to combat potential physical and emotional burdens. We hypothesized resident burnout remains high despite these limitations. METHODS: This web-based survey queried Ohio-based residents in general surgery, obstetrics–gynecology, family medicine, and internal medicine using general questions, Epworth Sleepiness Scale, Center for Epidemiologic Studies Depression scale, and Maslach Burnout Inventory. RESULTS: One hundred forty-nine residents responded: 39 general surgery (26.2%), 37 obstetrics–gynecology (24.8%), 27 family medicine (18.1%), and 46 internal medicine (30.9%). The majority was PGY-1 (36.2%), female (55%), aged 20–29 years (57.7%), and married (52.3%) with no children (75%). Many reported 5–6 hours of sleep per night (55.7%) and 0–3 days per week of exercise (81.9%). There were no differences between junior and senior residents regarding demographics, sleep, or activity; however, seniors had a higher Maslach Burnout Inventory personal accomplishment domain mean (standard deviation) score (39.0 [5.2] compared with 37.1 [7.2], P=.07). Factors associated with an increased score on the Maslach Burnout Inventory depression domain were more residents per year (P=.015) and graduation from a U.S. medical school (P<.001). Decreased physical activity was related to higher Maslach Burnout Inventory emotional exhaustion (P<.001). Increased Epworth Sleepiness Scale sleepiness and higher Center for Epidemiologic Studies Depression scale depression were associated with more work (P=.03; P=.019) and less sleep (P=.013; P=.007). CONCLUSIONS: Although the Accreditation Council for Graduate Medical Education restricts work hours for interns, we found no differences based on PGY level regarding Epworth Sleepiness Scale, Center for Epidemiologic Studies Depression scale, or Maslach Burnout Inventory except for the personal accomplishment domain score. At all levels, programs should encourage and teach coping strategies for sleepiness and depression.