228 - Exploring well-being among pediatric subspecialty fellows

Poster Number: 228
Publication Number: 228.332

Dana M. Foradori, Cleveland Clinic Lerner College of Medicine, Cleveland, OH, United States; Sarah Worley, Cleveland Clinic Children's, Cleveland, OH, United States; Emily N. Ashcraft, Cleveland Clinic Children's, Memphis, TN, United States; Sangeeta Krishna, Cleveland Clinic Children's, Cleveland, OH, United States

Background: Burnout is prevalent among physicians-in-training. The ACGME emphasizes support for trainee well-being, yet a paucity of literature explores the needs of fellows.

Objective: We aim to describe the state of well-being and associated needs of pediatric fellows, whom we hypothesize are a distinct population of advanced learners with unique professional and personal challenges.

Design/Methods: To develop the assessment tool, we iteratively revised a survey with feedback from program directors (PDs), core faculty, recent fellows, and statisticians at an academic center in the Midwest. We queried demographics, perceptions of well-being, well-being habits, fellowship and pandemic challenges, and support systems, as well as preferred learning modalities and topics. We assessed burnout with a standardized single-item burnout measure and professional fulfillment with the Stanford Professional Fulfillment Index. We emailed the 33-question survey to pediatric fellows. Descriptive statistics were reported.

Results: Response rate was 68% (17/25), with majority female, partnered, and at PGY-2/3 levels. Burnout was reported by 38% and professional fulfillment by 50%. Table 1 shows perceptions about well-being. While all fellows endorsed the importance of well-being, fewer felt confident in their practices or in seeking support from their PD (53%) or mental health services (59%). Fellows most frequently reported challenge with work-work balance (94%), referring to competing clinical, teaching, and scholarly responsibilities, and reported a broad range of additional challenges (Table 2). Fellows discussed well-being with co-fellows, family, friends, PDs, and mentors. Well-being support habits included exercise, nutrition, and family and social activities. Table 3 reflects preferred educational topics with prioritization of fatigue mitigation, time management, mentorship, and mindfulness. Fellows preferred learning via workshops, small groups, and mentorship.Conclusion(s): Fellows experience both burnout and suboptimal professional fulfillment. All fellows recognized the importance of well-being, but fewer were confident in their practices or comfortable seeking programmatic support. They endorsed multiple broad challenges, with nearly all reporting challenge in work-work balance, and preferred interactive learning about topics that mirrored challenges.

Results support a programmatic approach to supporting the specific well-being needs of fellows and will inform the development of a local longitudinal well-being curriculum and creation of peer support circles for pediatric fellows.
Table 1: Fellows' Ideas about Well-Being
Table 2: Fellowship Challenges