Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jul 1;274(1):12-17.
doi: 10.1097/SLA.0000000000004768.

The Role of Personal Accomplishment in General Surgery Resident Well-being

Rhami Khorfan  1 , Yue-Yung Hu  1   2 , Gaurava Agarwal  3 , Joshua Eng  1 , Taylor Riall  4 , Jennifer Choi  5 , Chandrakanth Are  6 , Tait Shanafelt  7 , Karl Y Bilimoria  1 , Elaine O Cheung  8
Affiliations

The Role of Personal Accomplishment in General Surgery Resident Well-being

Rhami Khorfan et al. Ann Surg. .

Abstract

Objective: To investigate the association of personal accomplishment (PA) with the other subscales, assess its association with well-being outcomes, and evaluate drivers of PA by resident level.

Background: Most studies investigating physician burnout focus on the emotional exhaustion (EE) and depersonalization (DP) subscales, neglecting PA. Therefore, the role of PA is not well understood.

Methods: General surgery residents were surveyed following the 2019 American Board of Surgery In-Training Examination regarding their learning environment. Pearson correlations of PA with EE and DP were assessed. Multivariable logistic regression models assessed the association of PA with attrition, job satisfaction, and suicidality and identified factors associated with PA by PGY.

Results: Residents from 301 programs were surveyed (85.6% response rate, N = 6956). Overall, 89.4% reported high PA, which varied by PGY-level (PGY1: 91.0%, PGY2/3: 87.7%, PGY4/5: 90.2%; P = 0.02). PA was not significantly correlated with EE (r = -0.01) or DP (r = -0.08). After adjusting for EE and DP, PA was associated with attrition (OR 0.60, 95%CI 0.46-0.78) and job satisfaction (OR 3.04, 95%CI 2.45-3.76) but not suicidality (OR 0.72, 95%CI 0.48-1.09). Although the only factor significantly associated with PA for interns was resident cooperation, time in operating room and clinical autonomy were significantly associated with PA for PGY2/3. For PGY4/5s, PA was associated with time for patient care, resident cooperation, and mentorship.

Conclusion: PA is a distinct metric of resident well-being, associated with job satisfaction and attrition. Drivers of PA differ by PGY level and may be targets for intervention to promote resident wellness and engagement.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interests.

Figures

Figure 1.
Figure 1.. Job Demands-Resources Model
Adapted with permission from W. B. Schaufeli. Applying the Job Demands-Resources model: A ‘how to’ guide to measuring and tackling work engagement and burnout. Organizational Dynamics (2017) 46, 120–132.
Figure 2.
Figure 2.. Factors Associated with Personal Accomplishment, Stratified by Postgraduate Year
Results from multivariable logistic regression models adjusted for resident gender, race/ethnicity, postgraduate year, program size, program type, and geography, with clustering by program. Solid circles represent odds ratios with 95% confidence interval bands. PGY: postgraduate year, OR: operating room. N=1,296 for PGY-1, N=2,244 for PGY-2/3, N=2,045 for PGY-4/5
See this image and copyright information in PMC

Comment in

References

    1. Han S, Shanafelt TD, Sinsky CA, et al. Estimating the Attributable Cost of Physician Burnout in the United States. Annals of internal medicine. June 4 2019;170(11):784–790. - PubMed
    1. Shanafelt TD, Balch CM, Bechamps GJ, et al. Burnout and career satisfaction among American surgeons. Annals of surgery. September 2009;250(3):463–471. - PubMed
    1. Shanafelt TD, Sloan JA, Habermann TM. The well-being of physicians. The American journal of medicine. April 15 2003;114(6):513–519. - PubMed
    1. Tawfik DS, Scheid A, Profit J, et al. Evidence Relating Health Care Provider Burnout and Quality of Care: A Systematic Review and Meta-analysis. Annals of internal medicine. October 15 2019;171(8):555–567. - PMC - PubMed
    1. Maslach C, Jackson SE, Leiter MP. Maslach Burnout Inventory Manual. 4th Edition ed. Menlo Park, CA: Mind Garden; 2017.

Publication types