Residents in anesthesiology training programs have high rates of burnout and depression, reports a survey study in the July issue of Anesthesia & Analgesia, official journal of the International Anesthesia Research Society (IARS).

The findings raise concerns that, “In addition to effects on the health of anesthesiology trainees, burnout and depression may also affect patient care and safety,” write Dr Gildasio S. de Oliveira, Jr, and colleagues of Northwestern University, Chicago.

Burnout and Depression Are Common in Anesthesia Trainees…

The researchers performed an Internet survey of U.S. anesthesiology residents nationwide. Confidential responses from 1,508 residents were analyzed to assess the frequency of burnout and depression, and whether trainees at high risk of these conditions would report more medical errors.

Forty-one percent of residents were considered at risk of burnout, based on high scores for emotional exhaustion and depersonalization and/or low scores for personal accomplishment. In addition, 22 percent of residents had possible depression, based on a standard screening test. Seventeen percent of trainees were at risk of both burnout and depression.

Compared to people of similar age, anesthesiology residents were nearly twice as likely to have screen positive for depression. They were also twice as likely to report suicidal thoughts.

Both burnout and depression were more likely for residents who worked more than 70 hours per week, those with higher alcohol use (more than five drinks per week), and female residents. Smoking was an additional risk factor for depression.

…With Possible Link to Increased Medical Errors

There was some evidence that burnout and depression affected the quality of patient care and the risk of medical errors. Rated on a 30-point “best practice” score, performance was about two points lower for residents at high risk for burnout and four points lower for those at high risk of both burnout and depression, compared to those at low risk.

Residents with burnout and depression also reported being less attentive to patients and making more mistakes with negative consequences for patients. One-third of residents with high burnout and depression risk said they had made multiple medication errors in the last year, compared to less than one percent of lower-risk responders.

Previous studies have identified medical residents as a group at high risk of burnout, which may lead to an increased risk of medical errors. The new study is the first to focus on the risk of burnout and depression among anesthesiology residents.

Burnout, depression, and suicidal thoughts are “very frequent” among anesthesiology residents, the results suggest. Dr de Oliveira and coauthors note that these problems may not only contribute to the risk of medical errors, but are also linked to high-risk behaviors such as smoking and alcohol use. The researchers discuss some possible approaches to reducing burnout in anesthesia trainees - such as balancing workload with quality of life or providing some type of psychological screening.

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Read the article in Anesthesia & Analgesia. The journal is published by Lippincott Williams & Wilkins, part of Wolters Kluwer Health.

About Anesthesia & Analgesia

Anesthesia & Analgesia was founded in 1922 and was issued bi-monthly until 1980, when it became a monthly publication. A&A is the leading journal for anesthesia clinicians and researchers and includes more than 500 articles annually in all areas related to anesthesia and analgesia, such as cardiovascular anesthesiology, patient safety, anesthetic pharmacology, and pain management. The journal is published on behalf of the IARS by Lippincott Williams & Wilkins (LWW), a division of Wolters Kluwer Health.

About the IARS

The International Anesthesia Research Society is a nonpolitical, not-for-profit medical society founded in 1922 to advance and support scientific research and education related to anesthesia, and to improve patient care through basic research. The IARS contributes nearly $1 million annually to fund anesthesia research; provides a forum for anesthesiology leaders to share information and ideas; maintains a worldwide membership of more than 15,000 physicians, physician residents, and others with doctoral degrees, as well as health professionals in anesthesia related practice; sponsors the SmartTots initiative in partnership with the FDA; and publishes the monthly journal Anesthesia & Analgesia in print and online.

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Connie Hughes
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