Presentation Authors: Daniel Marchalik*, Ariel Rodriguez, Jordan Alger, John Lynch, Jamie Padmore, Ross Krasnow, Washington, DC
Introduction: Surgical trainees experience a high rate of depression and suicidal ideation. Despite the high rate of burnout previously reported in urologists, no studies have addressed the rates of depression or suicidality in urology trainees.
Methods: We conducted a national REDCap-based survey study of urology trainees using a 50-question questionnaire in May of 2018. The survey included a demographic, depression, burnout, and quality of life questions. Depression and suicidal ideation was assessed using the PHQ-9; burnout was assessed using the Maslach Burnout Inventory.
Results: Responses were collected in 210 of 1,011 (20.9%) eligible participants. Overall, 37 (17.6%) met criteria for moderate-severe depression; suicidal ideation was identified in 25 residents (11.9%)-four times higher than the general population (Fig 1). Rates of suicidal thoughts were higher in those with moderate-severe depression (37.8% versus 5.8%, p < 0.001). Female residents were more likely than males to be depressed (29.2% vs 12.4%, p=0.005). Those working >80 hours had higher depression rates vs 60-80 and < 60 hours/wk (30.3%, 17.6 and 11%, respectively, p=0.003). Depression was more common in those without access to structured mentorship (23.7% versus 9.8%, p=0.010), mental health services (26.5% vs 8.9%, p=0.016), and in those with fatigue (29.5% vs 7.8%, p < 0.001). Residents with burnout had higher rates of depression (25.2% vs 1.5%, p < 0.001).On multivariate analysis, female gender (OR 3.0), fatigue (OR 3.4, p=0.016), emotional exhaustion (OR 3.9, p=0.024), and depersonalization (OR 3.1, p=0.04) were associated with depression (Table 1). On secondary analysis, being single (OR 4.8, 95%CI 1.5-15.4, p=0.008), emotional exhaustion (OR 6.1, 95%CI 1.4-26.6, p=0.016), and depersonalization (OR 4.5, 95%CI 1.2-16.2, p=0.023) were associated in increased odds of suicidal thoughts.
Conclusions: Urology trainees experience a high rate of depression and suicidal thoughts. These findings call for further inquiry into and action to promote resident well-being.