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From the Journals

Study: Medical Trainee Burnout Higher Among SGM

Lower workforce representation and higher burnout rates among SGM physicians represent key challenges, as approximately 7.6% of US adults and 22.3% of Generation Z identify as SGM, yet only 4.6% of attending physicians reported SGM status in this study.

Conexiant

Sexual and gender minority physicians and medical trainees experienced significantly higher rates of burnout, anxiety, and depression compared with their non-sexual and gender minority peers, according to a large cross-sectional survey study.

In the study, published in JAMA Network Open, investigators analyzed responses from 8,376 attending physicians and 2,564 medical trainees across 8 academic medical institutions between October 2019 and July 2021. Among the respondents, 4.6% of attending physicians and 8.3% of trainees identified as sexual and gender minority (SGM).

Key findings showed that SGM attending physicians had higher burnout rates (47.4% vs 35.4%, P < .001) and lower professional fulfillment (34.5% vs 40.4%, P < .001) compared with non-SGM colleagues. After adjusting for age and race/ethnicity, SGM attendings had a 57% higher risk of experiencing burnout.

Mental health disparities were notable. Among attendings, anxiety rates were higher in SGM vs non-SGM physicians (38.6% vs 25.8%, P < .001), as were depression rates (36.1% vs 24.8%, P < .001). Similar patterns emerged among trainees, with SGM residents reporting higher rates of anxiety (42.5% vs 34.6%, P < .001) and depression (42.9% vs 32.2%, P < .001).

The study population was predominantly non-Hispanic White (66.8%), followed by Asian (15.5%), other/multiple races (7.0%), Hispanic (4.6%), and non-Hispanic Black (2.4%). The majority of SGM attending physicians were between ages 30 to 49 years (65.8%), whereas 97.6% of SGM trainees were 39 years or younger.

Historical data from medical schools showed increasing SGM representation, with graduates identifying as gay/lesbian rising from 3.1% in 2016 to 4.1% in 2023, and bisexual identification increasing from 2.1% to 5.3%. Those reporting gender identity different from birth sex increased from 1.1% in 2022 to 1.3% in 2023.

The investigators used validated assessment tools, including the Professional Fulfillment Index (PFI) for measuring burnout and fulfillment, and the PROMIS short-form four-item measure for anxiety and depression. The overall response rate was 52.6%, with similar rates between attendings (53.5%) and trainees (50.2%).

While SGM attending physicians showed higher intent to leave their institutions (33.2% vs 30.9%, P < .001), this difference was not observed among trainees. Statistical significance persisted after controlling for demographic variables.

The study represented the first large-scale, multicenter assessment of SGM status prevalence among physicians and its relationship to occupational well-being.

Conflict of interest disclosures can be found in the study.