Background: Physicians are at high risk for burnout when compared to the general population. Burnout affects health, relationships, motivation, and patient outcomes. Elements of emergency medicine (EM) may make EM residents/attendings more vulnerable to stress. Examining physician resilience and finding ways to implement change is essential to improving the culture of residency training. The objective of this study was to compare well-being and stress between EM residents and other residents and to compare EM residents and attendings.
Methods: Residents across 19 training programs at a single academic medical center were recruited to voluntarily complete an anonymous survey to assess their overall well-being and stress using Physician Well-Being Index (measures negative indicators of wellness- Mayo), Wellness Scale (measures positive indicators- Wayne State University) and Perceived Stress Scales. Responses from EM were compared against residents/ attendings across other residency programs (Mann-Whitney). This survey was IRB exempt.
Results: 303 residents across the institution responded; 37 of 43 (86%) EM residents completed the survey. Of EM residents, 41% reported low stress, 51% reported moderate stress, 8% reported high stress. On average, EM residents had similar Perceived Stress (14.91 EM, 15.19 nonEM) Wellness (3.69 EM, 3.64 nonEM) and Well-being (2.35 EM, 2.35 nonEM) compared to other residents. For attendings, 189 across the institution responded to the survey and 31 (53% response rate) Emergency Medicine attendings responded. Perceived Stress (13.84 EM, 15.49 nonEM), Wellness (3.88 EM, 3.92nonEM) and Well-being (2.0 EM, 2.0 nonEM) scales were similar for EM compared to other specialty attendings (p>.05). EM scores were close to the mean for each instrument while other departments were much better or worse.
Conclusion: EM residents and attendings have moderate to high stress and low well-being. EM is attributed to having a high burnout rate but these results show similar data to burnout as other specialties. Despite reporting high stress, perceived stress is lower, which may be attributed to a supportive clinical environment. As an institution, as well as the department, stress and well-being need to be addressed on multiple levels for all providers. These instruments are useful for benchmark comparisons and to track internal improvement efforts.