Data describing factors associated with work-life balance, burnout, and career and life satisfaction for early career pediatricians are limited. We sought to identify personal and work factors ...related to these outcomes.
We analyzed 2013 survey data of pediatricians who graduated residency between 2002 and 2004. Dependent variables included: (1) balance between personal and professional commitments, (2) current burnout in work, (3) career satisfaction, and (4) life satisfaction. Multivariable logistic regression examined associations of personal and work characteristics with each of the 4 dependent variables.
A total of 93% of participants completed the survey (n = 840). A majority reported career (83%) and life (71%) satisfaction. Fewer reported current appropriate work-life balance (43%) or burnout (30%). In multivariable modeling, excellent/very good health, having support from physician colleagues, and adequate resources for patient care were all found to be associated with a lower prevalence of burnout and a higher likelihood of work-life balance and career and life satisfaction. Having children, race, and clinical specialty were not found to be significantly associated with any of the 4 outcome measures. Female gender was associated with a lower likelihood of balance and career satisfaction but did not have an association with burnout or life satisfaction.
Burnout and struggles with work-life balance are common; dissatisfaction with life and career are a concern for some early career pediatricians. Efforts to minimize these outcomes should focus on encouragement of modifiable factors, including health supervision, peer support, and ensuring sufficient patient care resources.
Abstract Objective In October 2016, the American Board of Medical Specialties approved the petition for pediatric hospital medicine (PHM) to become the newest pediatric subspecialty. Knowledge about ...residents entering the PHM workforce is needed to inform certification and fellowship accreditation. This study describes the characteristics of graduating pediatric residents with PHM positions and identifies factors associated with post-residency position choices. Methods We analyzed data from the American Academy of Pediatrics Annual Survey of Graduating Residents, 2006-2015. Chi-square tests were used to compare responses between residents entering PHM to those entering subspecialty fellowships, and to compare residents entering PHM at community and tertiary hospitals. We used multivariable logistic regression to identify associations between resident and training characteristics and position choices. Results 5969 respondents completed the survey (60.6% response rate); 593 (10.3%) reported that they were entering PHM and 1954 (33.9%) reported subspecialty fellowships. Of residents entering PHM, 345 (60.7%) reported positions at tertiary care hospitals and 194 (34.2%) reported positions at community hospitals. 70% of residents entering PHM envisioned long-term PHM careers, with PHM career goals more frequently reported among residents entering community hospitalist positions (p<0.01). In multivariable analysis, residents entering PHM were significantly more likely to be female, to have children, to report that family factors limited their job selection, and to have higher levels of educational debt than residents entering fellowships. Conclusions Factors associated with post-residency PHM positions, including substantial educational debt and sociodemographic characteristics, may influence development of the field as the specialty pursues fellowship accreditation.
To examine trends in pediatric residents' training and job search experiences from 2003 through 2009.
Annual national random samples of 500 graduating pediatric residents from 2003 through 2005 and ...1000 from 2006 through 2009 were surveyed. Responses were compared across years to identify trends. We examined resident demographics, training, satisfaction, career intentions, and job search experiences. Overall response rate was 61%.
Between 2003 and 2009, there was an increase in the proportion of female graduating pediatric residents (69%-75%), residents from international medical schools (15%-23%), and levels of educational debt among the subgroup of residents with debt ($139 945 in 2003 to $166 972 in 2009). Residents consistently reported (>90% of residents) that they would choose pediatrics again if they had the choice. By 2009, the majority was very satisfied with the quality of their training in most areas, with ratings improving across years in caring for children with special health care needs, evidence-based medicine, and using information technology in practice. Although primary care remained the most common clinical practice goal, there was a modest decline in interest in primary care practice across survey years, whereas interest in subspecialty practice increased. Residents accepting both general pediatric practice and hospitalist positions reported less difficulty in their job search over time.
Despite continually changing demographics of pediatric training programs, residents overall remain very satisfied with their decision to become pediatricians. Pediatricians continue to face difficult financial challenges associated with rising debt, but they also report increasing job search success.
To examine US pediatricians and US adults on 3 self-reported health measures (sleep, physical activity, and general health status) and to assess factors related to these measures for each group.
...Pediatrician data were collected through a 2012 American Academy of Pediatrics Periodic Survey (response rate = 64.0%). US population data originated from the 2012 National Health Interview Survey (response rate = 61.2%). Analytic samples included those currently working and ≥30 years old and were restricted to post-trainees (pediatricians; n = 854) and US adults with at least a bachelor's degree (n = 5447). Accounting for sample demographic differences, predicted probabilities compared the proportions reporting ≥7 hours of sleep, meeting physical activity recommendations, and reporting very good or excellent health. Multivariable logistic regression examined characteristics associated with health measures for pediatricians and US adults separately.
When the US population demographic profile was adjusted to resemble the pediatrician sample, 7 in 10 pediatricians (71.2%; confidence interval CI, 68.0–74.5) and US adults (69.9%; CI, 67.8–72.0) reported ≥7 hours of sleep. Pediatricians were more likely than US adults to meet physical activity recommendations (71.4%; CI, 68.0–74.8 vs. 62.9%; CI, 60.6–65.2) and less likely to report very good or excellent health (74.3%; CI, 71.2–77.3 vs. 80.2%; CI, 78.3–82.1). In pediatrician and US population multivariable models, self-identified Asians and those working ≥50 hours were less likely to get ≥7 hours of sleep (P < .05).
Most US pediatricians and US adults reported getting the recommended amounts of sleep and physical activity and rated their health as very good or excellent. Those working fewer hours reported more sleep. Organization-directed approaches may be needed to help physicians maintain and improve their health.
To examine current levels of educational debt among pediatric residents and the relationship between educational debt and career intentions.
Annual national random samples of 1000 graduating ...pediatric residents from 2006 through 2010 were surveyed. Responses were combined. We used t tests and 1-way analysis of variance to compare debt, linear regression to examine factors associated with educational debt, and logistic regression to assess the influence of debt on clinical practice goal. Response rate was 61%.
Three in 4 residents reported having educational debt. The mean debt (in 2010 dollars) among all residents, which included spouse's debt if married, increased 34% from $104 000 in 2006 to $139 000 in 2010. Among the subgroup who reported having any debt, the mean debt increased 24% from $146 000 in 2006 to $181 000 in 2010. Residents had varied clinical practice goals; 43% had goals that required fellowship training (subspecialty and combined primary-subspecialty) and 57% had goals not typically requiring fellowship training (primary care and hospitalist). In multivariate analyses, debt level (low, medium, high) remained an independent predictor of practice goal. Residents with medium debt (adjusted odds ratio: 1.46, 95% confidence interval: 1.16-1.84) and high debt (adjusted odds ratio: 1.51; 95% confidence interval: 1.20-1.90) had higher odds than residents with low debt of having a practice goal that does not typically require fellowship training. Other factors also had an independent association with career choice.
Multiple factors shape decisions about careers. Higher educational debt is one factor that may push residents toward primary care or hospitalist practice, rather than pursuing fellowship training.
Physicians must balance career and home responsibilities, yet previous studies on work-life balance are focused primarily on work-based tasks. We examined gender discrepancies and factors related to ...household responsibilities and work-life balance among pediatricians.
We used 2015 data from the American Academy of Pediatrics Pediatrician Life and Career Experience Study, a longitudinal study of early-career pediatricians. χ
tests and multivariable logistic regression were used to examine the effects of gender on household responsibilities, satisfaction, and work-life balance attainment. We formally reviewed responses from 2 open-ended questions on work-life balance challenges and strategies for common themes.
Seventy-two percent of participants completed the survey (1293 of 1801). Women were more likely than men to report having primary responsibility for 13 of 16 household responsibilities, such as cleaning, cooking, and routine care of children (all
< .001). All gender differences except budget management remained significant when controlling for part-time work status and spouse or partner work status (
< .05). Women were less satisfied with their share of responsibilities relative to others (52% vs 62%;
< .001), and few women and men report being very successful at achieving balance between their job and other life areas (15% vs 19%, respectively;
= .05). Open-ended responses (
= 1145) revealed many barriers to achieving work-life balance. Strategies to increase work-life balance included reducing work hours, outsourcing household-related work, and adjustments to personal responsibilities and relationships.
Female pediatricians spend more time on household responsibilities than male pediatricians, and gender is a key factor associated with work-life balance satisfaction.
Abstract Objective To determine the relationship between pediatric residency program size and resident demographic characteristics, career intentions, and training experiences. Methods Annual ...national random samples of 1000 graduating pediatrics residents were surveyed between 2010 and 2014. Response years were pooled for analysis, and trends in resident demographic characteristics, career intentions and job search, and training experiences were compared across program class size: small (<10 residents per class), medium (10–19 residents per class), and large (≥20 residents per class). Results Overall response rate was 61% (3038 of 5000). Primary care goals at the end of residency varied according to program size: 45.9% for small programs, 43.4% for medium programs, and 35.1% for large programs. Reports of excellent or very good preparation for subspecialty fellowship and hospitalist positions increased across program size, whereas primary care preparation reports decreased. Only half of the residents in large programs who enter primary care believe they are prepared and less than half in small programs who accept subspecialty fellowship positions believe they are prepared for these new positions. Residents in medium and large programs report being most prepared for hospitalist work. Conclusions Notable numbers of residents in small programs pursue subspecialties and notable numbers in large programs enter primary care. However, residents believe they are less prepared for primary care as program size increases and less prepared for subspecialty training as program size decreases. These findings suggest that the training experiences of some residents do not optimally align with their future practice.
Pediatricians Working Part-Time Has Plateaued Cull, William L., PhD; Frintner, Mary Pat, MSPH; O'Connor, Karen G., BS ...
The Journal of pediatrics,
04/2016, Letnik:
171
Journal Article
Recenzirano
Objective To examine trends in pediatricians working part-time and residents seeking part-time work and to examine associated characteristics. Study design The American Academy of Pediatrics (AAP) ...Periodic Survey of Fellows and the AAP Annual Survey of Graduating Residents were used to examine part-time employment. Fourteen periodic surveys were combined with an overall response rate of 57%. Part-time percentages were compared for surveys conducted from 2006-2009 and 2010-2013. The AAP Annual Surveys of Graduating Residents (combined response rate = 60%) from 2006-2009 were compared with 2010-2013 surveys for residents seeking and obtaining part-time positions following training. Multivariable logistic regression models identified characteristics associated with part-time work. Results Comparable percentages of pediatricians worked part-time in 2006-2009 (23%) and 2010-2013 (23%). There was similarly no statistically significant difference in residents seeking part-time work (30%-28%), and there was a slight decline in residents accepting part-time work (16%-13%, aOR .75, 95% CI .56-.96). Increases in working part-time were not found for any subgroups examined. Women consistently were more likely than men to work part-time (35% vs 9%), but they showed different patterns of part-time work across age. Women in their 40s (40%) were more likely than other women (33%) and men in their 60s (20%) were more likely than other men (5%) to work part-time. Conclusions There has been a levelling off in the number of pediatricians working part-time and residents seeking part-time work. Overall, women remain more likely to work part-time, although 1 in 5 men over 60 work part-time.
Abstract Objective To compare job search experience and postresidency position of pediatric residents on the basis of childhood location (United States or international) and medical school location ...(American medical graduates AMG or international medical graduate IMG). Methods Annual national random samples of 1000 graduating pediatric residents from 2009 to 2013 were surveyed. Multivariable analyses, controlling for resident and program characteristics, compared job search experiences and postresidency positions among 4 groups categorized by childhood and medical school location: US-AMG, US-IMG, international-AMG, and international-IMG. Results A total of 3027 graduating residents (61.1%) responded: 75.2% US-AMG, 15.8% international-IMG, 6.3% US-IMG, and 2.7% international-AMG. The 4 groups varied by demographics (age, race, gender, marital status, children, bi- or multilingual family), educational debt, residency program region and size, and Spanish proficiency ( P < .01). The US-AMG were least likely to have a bi- or multilingual family (25.7%) or be proficient in Spanish (15.0%). One-third (34.5%) accepted fellowship positions. International-IMG and US-IMG were more likely than US-AMG to choose fellowship positions (adjusted odds ratio aOR, 2.04; 95% confidence interval CI, 1.52–2.74; aOR, 1.77; 95% CI, 1.25–2.52, respectively). Among residents who applied for general pediatric or hospitalist positions, 23.1% reported moderate to considerable difficulty in their job search, and 44.1% accepted positions in underserved areas. International-IMG and US-IMG were more likely than US-AMG to report job search difficulty (aOR, 2.49; 95% CI, 1.55–3.98; aOR, 1.78; 95% CI, 1.04–3.06, respectively), and international-IMG were more likely to accept positions in underserved areas (aOR, 1.68; 95% CI, 1.07–2.63). Conclusions Multiple factors are involved in pediatrician's career choices. When childhood location is considered with medical school location, there were differences between groups in demographics, job search difficulty, and career intentions.
Abstract Objective Little is known about the association between mentorship and career choice during residency in pediatrics. This study examines graduating residents with mentors who provide career ...advice and the relationship between having a mentor who is a subspecialist and having a subspecialty practice goal. Methods National, random samples of 1000 graduating pediatrics residents were surveyed each year from 2006 to 2012; 4197 (61%) responded. Responses were pooled across years to examine mentor specialty and career goal at time of residency graduation. Multivariable logistic regression was used to examine relationships between mentor specialty and career goal at the time of graduation. Results Most (87%) residents reported having a mentor who provided career advice during residency; the proportion linearly increased from 83% in 2006 to 87% in 2012; P < .05. Forty-five percent of those with mentors had a mentor who was a subspecialist; 55% had a generalist as a mentor. Overall, 45% of residents had a subspecialty career goal at time of graduation. After controlling for career goal at the start of residency and resident characteristics, residents with a subspecialist mentor were more likely to have a subspecialty career goal at time of graduation (adjusted odds ratio = 5.25; 95% confidence interval, 4.41–6.25). Residents who were male, without children, without debt, not married, not minority, and from larger residency programs were also more likely to have a subspecialty career goal at the time of graduation from residency. Conclusions Almost 9 in 10 pediatric residents have a mentor who provides career advice. Although multiple factors shape decisions about careers, mentor specialty is one factor that might encourage residents to pursue fellowship training.
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