The health and wellbeing of cardiology trainees in the united kingdom

Abstract

Abstract Background Cardiology is a rewarding medical speciality. However, the intense workload can burden cardiologists with physical and psychological demands, and risks contributing to ill health. Cardiologists suffering poor health may increase absenteeism, stretching a workforce, and potentially reduce quality of patient care. Purpose We sought to describe the prevalence of physical and mental health conditions of cardiology trainees within the United Kingdom. We also aimed to identify factors associated with risk of burnout and negative drivers of psychological wellbeing. Methods The British Junior Cardiologists Association (BJCA) is a professional body which represents cardiology trainees in the UK. The BJCA conducts an annual survey of trainees, covering various aspects of working lives and all UK cardiology trainees are eligible to participate. For the 2023 survey, in addition to demographics and training questions, we asked questions on ill health, burnout, support for wellbeing, and invited responders to complete validated screening questionnaires for anxiety (GAD-7) and depression (PHQ-9). Responders were eligible for inclusion if they consented to take part in the health and wellbeing questions, and if they had completed four demographic questions. Anxiety and depression were deemed significant if scoring in the moderate or severe range (PHQ-9≥10; GAD7≥10). Significant burnout was defined as responders indicating being "somewhat" or "very" close to burnout. Logistic regression was used to determine odds ratios (OR) between univariate predictors of burnout, anxiety, and depression. Results Of the 398 responders, 212 fulfilled inclusion criteria (66% male, age 34±4 years, 42% had dependents). A physical health condition was reported by 11% of trainees, and 9% a reported a mental health condition. Significant burnout was reported by 76% of trainees. Those with dependents reported lower rates of burnout compared to those without (OR 0.35, 95% CI 0.18-0.67, p<0.01). Significant depression scores were reported by 25%, significant anxiety scores in 18%, and significant scores of either depression or anxiety in 29% (Fig 1). Scores from 17% of trainees were consistent with significant depression or anxiety and yet not known to have a mental health condition. Less Than Full Time trainees reported higher rates of anxiety (OR 4.38, 95% CI 1.37-14.10, p=0.01) and depression (OR 10.31, 95% CI 2.98-35.71, p<0.01). Training was reported to have a negative impact on physical health by 43% of trainees, and 47% reported a negative impact on mental health. Principal drivers of negative wellbeing included the amount of service provision; curriculum requirements, and lack of training opportunities (Fig 2). Conclusions The prevalence of anxiety, depression and burnout is high amongst cardiology trainees. Urgent action is needed by training bodies and employers to ensure training programmes consider the physical and mental wellbeing of trainees.Depression and Anxiety ScreeningNegative Drivers of Wellbeing