OBJECTIVE:To study prevalence of and factors that contribute to burnout, career satisfaction, and well-being in US neurologists.
METHODS:A total of 4,127 US American Academy of Neurology member ...neurologists who had finished training were surveyed using validated measures of burnout, career satisfaction, and well-being from January 19 to March 21, 2016.
RESULTS:Response rate was 40.5% (1,671 of 4,127). Average age of participants was 51 years, with 65.3% male and nearly equal representation across US geographic regions. Approximately 60% of respondents had at least one symptom of burnout. Hours worked/week, nights on call/week, number of outpatients seen/week, and amount of clerical work were associated with greater burnout risk. Effective support staff, job autonomy, meaningful work, age, and subspecializing in epilepsy were associated with lower risk. Academic practice (AP) neurologists had a lower burnout rate and higher rates of career satisfaction and quality of life than clinical practice (CP) neurologists. Some factors contributing to burnout were shared between AP and CP, but some risks were unique to practice setting. Factors independently associated with profession satisfaction included meaningfulness of work, job autonomy, effectiveness of support staff, age, practicing sleep medicine (inverse relationship), and percent time in clinical practice (inverse relationship). Burnout was strongly associated with decreased career satisfaction.
CONCLUSIONS:Burnout is common in all neurology practice settings and subspecialties. The largest driver of career satisfaction is the meaning neurologists find in their work. The results from this survey will inform approaches needed to reduce burnout and promote career satisfaction and well-being in US neurologists.
OBJECTIVE:This study estimates current and projects future neurologist supply and demand under alternative scenarios nationally and by state from 2012 through 2025.
METHODS:A microsimulation supply ...model simulates likely career choices of individual neurologists, taking into account the number of new neurologists trained each year and changing demographics of the neurology workforce. A microsimulation demand model simulates utilization of neurology services for each individual in a representative sample of the population in each state and for the United States as a whole. Demand projections reflect increased prevalence of neurologic conditions associated with population growth and aging, and expanded coverage under health care reform.
RESULTS:The estimated active supply of 16,366 neurologists in 2012 is projected to increase to 18,060 by 2025. Long wait times for patients to see a neurologist, difficulty hiring new neurologists, and large numbers of neurologists who do not accept new Medicaid patients are consistent with a current national shortfall of neurologists. Demand for neurologists is projected to increase from ∼18,180 in 2012 (11% shortfall) to 21,440 by 2025 (19% shortfall). This includes an increased demand of 520 full-time equivalent neurologists starting in 2014 from expanded medical insurance coverage associated with the Patient Protection and Affordable Care Act.
CONCLUSIONS:In the absence of efforts to increase the number of neurology professionals and retain the existing workforce, current national and geographic shortfalls of neurologists are likely to worsen, exacerbating long wait times and reducing access to care for Medicaid beneficiaries. Current geographic differences in adequacy of supply likely will persist into the future.
OBJECTIVETo examine age and sex differences in burnout, career satisfaction, and well-being in US neurologists.
METHODSQuantitative and qualitative analyses of menʼs (n = 1,091) and womenʼs (n = 580) ...responses to a 2016 survey of US neurologists.
RESULTSEmotional exhaustion in neurologists initially increased with age, then started to decrease as neurologists got older. Depersonalization decreased as neurologists got older. Fatigue and overall quality of life in neurologists initially worsened with age, then started to improve as neurologists got older. More women (64.6%) than men (57.8%) met burnout criteria on univariate analysis. Women respondents were younger and more likely to work in academic and employed positions. Sex was not an independent predictive factor of burnout, fatigue, or overall quality of life after controlling for age. In both men and women, greater autonomy, meaning in work, reasonable amount of clerical tasks, and having effective support staff were associated with lower burnout risk. More hours worked, more nights on call, higher outpatient volume, and higher percent of time in clinical practice were associated with higher burnout risk. For women, greater number of weekends doing hospital rounds was associated with higher burnout risk. Women neurologists made proportionately more negative comments than men regarding workload, work–life balance, leadership and deterioration of professionalism, and demands of productivity eroding the academic mission.
CONCLUSIONSWe identified differences in burnout, career satisfaction, and well-being in neurologists by age and sex. This may aid in developing strategies to prevent and mitigate burnout and promote professional fulfillment for different demographic subgroups of neurologists.
To understand the challenges and facilitators of a successful academic neurology research career broadly and to identify gender-based disparities specifically.BACKGROUND AND OBJECTIVESTo understand ...the challenges and facilitators of a successful academic neurology research career broadly and to identify gender-based disparities specifically.In 2019, participants self-identifying as researchers, preregistered for the American Academy of Neurology (AAN) Annual Meeting, ≥7 years out of residency, and authors of ≥1 AAN meeting abstract submission (2006-2009) were selected to participate in the qualitative study (purposeful sampling strategy). To increase diversity, 15 participants were invited by members involved in the AAN until interviews were complete. The AAN at the time of the study asked gender using sex-based terms. Participants were asked predetermined and open-ended questions. Themes were generated using a flexible coding methodology.METHODSIn 2019, participants self-identifying as researchers, preregistered for the American Academy of Neurology (AAN) Annual Meeting, ≥7 years out of residency, and authors of ≥1 AAN meeting abstract submission (2006-2009) were selected to participate in the qualitative study (purposeful sampling strategy). To increase diversity, 15 participants were invited by members involved in the AAN until interviews were complete. The AAN at the time of the study asked gender using sex-based terms. Participants were asked predetermined and open-ended questions. Themes were generated using a flexible coding methodology.Sixty neurologists (31 women, 29 men) participated in the focus groups and individual interviews. Six predetermined domains relevant to a successful neurology research career were explored: success definitions, facilitators, barriers, biases and harassment, mitigation strategies, and participant recommendations. Gender-based differences were noted during discussions focused on barriers and biases and harassment. Lack of women mentors, under-representation of women in senior faculty positions, and competing responsibilities when children are young were identified as barriers to women's success. Participants acknowledged that known gender disparities in compensation, academic promotion, and publications disproportionately affect women. Women shared more experiences of bias and harassment. Some men felt that gender-based biases were minimal to nonexistent. Participants shared their recommendations on ways to mitigate gender disparities and pursue a neurology research career. Leadership involvement locally and nationally in advocating and implementing change outside academic institutions was also mentioned as being valuable.RESULTSSixty neurologists (31 women, 29 men) participated in the focus groups and individual interviews. Six predetermined domains relevant to a successful neurology research career were explored: success definitions, facilitators, barriers, biases and harassment, mitigation strategies, and participant recommendations. Gender-based differences were noted during discussions focused on barriers and biases and harassment. Lack of women mentors, under-representation of women in senior faculty positions, and competing responsibilities when children are young were identified as barriers to women's success. Participants acknowledged that known gender disparities in compensation, academic promotion, and publications disproportionately affect women. Women shared more experiences of bias and harassment. Some men felt that gender-based biases were minimal to nonexistent. Participants shared their recommendations on ways to mitigate gender disparities and pursue a neurology research career. Leadership involvement locally and nationally in advocating and implementing change outside academic institutions was also mentioned as being valuable.Our findings may not be generalizable to academic neurologists outside the United States. Women academic neurology researchers experienced disparities across several domains affecting success: lower compensation, fewer women mentors, bias, and harassment. Women are less likely to be promoted, have less research success, and job satisfaction. Shared experiences of bias and harassment among women neurology researchers indicate continuing opportunity for education among departments and colleagues for preventive measures. These qualitative results indicate gender disparities among US-based neurology researchers and highlight the importance of the continued need to work toward equality and equity in disparate gender-related issues in the careers of neurology researchers.DISCUSSIONOur findings may not be generalizable to academic neurologists outside the United States. Women academic neurology researchers experienced disparities across several domains affecting success: lower compensation, fewer women mentors, bias, and harassment. Women are less likely to be promoted, have less research success, and job satisfaction. Shared experiences of bias and harassment among women neurology researchers indicate continuing opportunity for education among departments and colleagues for preventive measures. These qualitative results indicate gender disparities among US-based neurology researchers and highlight the importance of the continued need to work toward equality and equity in disparate gender-related issues in the careers of neurology researchers.
OBJECTIVE:To study prevalence of and factors contributing to burnout, career satisfaction, and well-being in US neurology residents and fellows.
METHODS:A total of 938 US American Academy of ...Neurology member neurology residents and fellows were surveyed using standardized measures of burnout, career satisfaction, and well-being from January 19 to March 21, 2016.
RESULTS:Response rate was 37.7% (354/938); about 2/3 of responders were residents and 1/3 were fellows. Median age of participants was 32 years and 51.1% were female. Seventy-three percent of residents and 55% of fellows had at least one symptom of burnout, the difference largely related to higher scores for depersonalization among residents. For residents, greater satisfaction with work–life balance, meaning in work, and older age were associated with lower risk of burnout; for fellows, greater satisfaction with work–life balance and effective support staff were associated with lower risk of burnout. Trainees experiencing burnout were less likely to report career satisfaction. Career satisfaction was more likely among those reporting meaning in work and more likely for those working in the Midwest compared with the Northeast region.
CONCLUSIONS:Burnout is common in neurology residents and fellows. Lack of work–life balance and lack of meaning in work were associated with reduced career satisfaction and increased risk of burnout. These results should inform approaches to reduce burnout and promote career satisfaction and well-being in US neurology trainees.
Many companies in different industrial sectors are exploring alternative work schedules to deal with diverse problems associated with shiftwork. The use of extended workday schedules (regular shift ...lengths exceeding 8 h with compressed workweeks) is attracting growing interest in many industries that use continuous operations. To address concerns regarding possible fatigue effects on safety and work performance associated with such schedules, the U.S. Bureau of Mines conducted a two-phase study at an underground metal mine in western Canada. Data were collected before and after a group of workers employed at the mine changed from an 8- to a 12-h schedule. Results indicate nearly unanimous acceptance and improved sleep quality associated with the new schedule. In general, fatigue-sensitive behavioral and physiological performance measures show either no change or improvement with 12-h shifts. We conclude that the extended workday schedule should be retained but periodically reevaluated.
Working extended workshifts and overtime has been linked to three basic manifestations of fatigue, involving decrements in behavioral performance and physiological function, plus subjective ...complaints. Fatigue, in turn, may be associated with performance decrements and accidents. This report describes findings from a prospective study of changes in an array of subjective response and objective performance measures, before and after workers in an underground mine converted from an 8 h to a 12 h rotating shift schedule. The study employed a psychophysiological approach to work schedule evaluation. An array of putative fatigue-related measures were collected, encompassing pre-, mid-, and post-shift measures of cognitive and psychomotor behavioral performance, estimated maximal oxygen uptake (VO
2max) and heart rate (HR) recovery levels using submaximal exercise testing, and subjective self-report mood and sleepiness responses. Continuous heart rate records during work activity across the shift also were collected. There are no significant main effects of schedule (8 h versus 12 h) for most measures. However, the continuous HR findings suggest pacing of work effort on 12 h relative to 8 h shifts. Pre- to post-shift changes in HR recovery and in mood self-report responses are consistent with differential fatigue effects of 12 h relative to 8 h shifts. Results support the conclusion that the extended workdays schedule evaluated in this study is not associated with pronounced fatigue effects, possibly because of moderation of work effort across 12 h compared with 8 h shifts.
Relevance to industry
Use of extended workdays is becoming more popular in various industries. However, there currently is little information available that allows objective prediction of risks and benefits associated with the use of extended workdays, particularly in physically demanding environments. This study was designed to provide such information by assessing possible differential performance effects of fatigue associated with 12 h versus 8 h workshifts during underground mining work.
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