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December 2022; 1 (2) Research ArticleOpen Access

Education Research: Impact of Burnout on Neurology Residents and Research Fellows in Europe

View ORCID ProfileGiovanni Di Liberto, Giuseppina Baldizzi, View ORCID ProfileVanessa Carvalho, View ORCID ProfileLuca Cuffaro, View ORCID ProfileAnna Sauerbier, Lisa Klingelhoefer, View ORCID ProfileNina Vashchenko, Lucia Pavlakova, Anja Sander, View ORCID ProfileMarianne de Visser, Paul A.J.M. Boon, Elena Moro, Claudio Bassetti
First published November 29, 2022, DOI: https://doi.org/10.1212/NE9.0000000000200035
Giovanni Di Liberto
From the Department of Clinical Neurosciences (G.D.L., G.B.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Department of Neurosciences and Mental Health (Neurology) (V.C.), Hospital Santa Maria-CHLN, and Centro de Estudos Egas Moniz (V.C.), Faculdade de Medicina, Universidade de Lisboa, Portugal; Department of Health Sciences (L.C.), Clinical Neurology Unit, ASST Santi Paolo & Carlo, Milan, Italy; Department of Neurology (A. Sauerbier), Faculty of Medicine and University Hospital Cologne, University of Cologne; Department of Neurology (L.K.), Technical University Dresden, Germany; University Hospital of Neurological Disorders (N.V.), Sechenov First Moscow State Medical University, Russia; European Academy of Neurology (L.P., A. Sander), Head Office, Vienna, Austria; Department of Neurology (M.d.V.), Academic Medical Center, Amsterdam, the Netherlands; Department of Neurology (P.A.J.M.B.), Ghent University Hospital, Belgium; Division of Neurology (E.M.), CHU of Grenoble, Grenoble Institute of Neurosciences, Grenoble Alpes University, France; and Department of Neurology (C.B.), Inselspital, University of Bern, Switzerland.
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Giuseppina Baldizzi
From the Department of Clinical Neurosciences (G.D.L., G.B.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Department of Neurosciences and Mental Health (Neurology) (V.C.), Hospital Santa Maria-CHLN, and Centro de Estudos Egas Moniz (V.C.), Faculdade de Medicina, Universidade de Lisboa, Portugal; Department of Health Sciences (L.C.), Clinical Neurology Unit, ASST Santi Paolo & Carlo, Milan, Italy; Department of Neurology (A. Sauerbier), Faculty of Medicine and University Hospital Cologne, University of Cologne; Department of Neurology (L.K.), Technical University Dresden, Germany; University Hospital of Neurological Disorders (N.V.), Sechenov First Moscow State Medical University, Russia; European Academy of Neurology (L.P., A. Sander), Head Office, Vienna, Austria; Department of Neurology (M.d.V.), Academic Medical Center, Amsterdam, the Netherlands; Department of Neurology (P.A.J.M.B.), Ghent University Hospital, Belgium; Division of Neurology (E.M.), CHU of Grenoble, Grenoble Institute of Neurosciences, Grenoble Alpes University, France; and Department of Neurology (C.B.), Inselspital, University of Bern, Switzerland.
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Vanessa Carvalho
From the Department of Clinical Neurosciences (G.D.L., G.B.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Department of Neurosciences and Mental Health (Neurology) (V.C.), Hospital Santa Maria-CHLN, and Centro de Estudos Egas Moniz (V.C.), Faculdade de Medicina, Universidade de Lisboa, Portugal; Department of Health Sciences (L.C.), Clinical Neurology Unit, ASST Santi Paolo & Carlo, Milan, Italy; Department of Neurology (A. Sauerbier), Faculty of Medicine and University Hospital Cologne, University of Cologne; Department of Neurology (L.K.), Technical University Dresden, Germany; University Hospital of Neurological Disorders (N.V.), Sechenov First Moscow State Medical University, Russia; European Academy of Neurology (L.P., A. Sander), Head Office, Vienna, Austria; Department of Neurology (M.d.V.), Academic Medical Center, Amsterdam, the Netherlands; Department of Neurology (P.A.J.M.B.), Ghent University Hospital, Belgium; Division of Neurology (E.M.), CHU of Grenoble, Grenoble Institute of Neurosciences, Grenoble Alpes University, France; and Department of Neurology (C.B.), Inselspital, University of Bern, Switzerland.
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Luca Cuffaro
From the Department of Clinical Neurosciences (G.D.L., G.B.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Department of Neurosciences and Mental Health (Neurology) (V.C.), Hospital Santa Maria-CHLN, and Centro de Estudos Egas Moniz (V.C.), Faculdade de Medicina, Universidade de Lisboa, Portugal; Department of Health Sciences (L.C.), Clinical Neurology Unit, ASST Santi Paolo & Carlo, Milan, Italy; Department of Neurology (A. Sauerbier), Faculty of Medicine and University Hospital Cologne, University of Cologne; Department of Neurology (L.K.), Technical University Dresden, Germany; University Hospital of Neurological Disorders (N.V.), Sechenov First Moscow State Medical University, Russia; European Academy of Neurology (L.P., A. Sander), Head Office, Vienna, Austria; Department of Neurology (M.d.V.), Academic Medical Center, Amsterdam, the Netherlands; Department of Neurology (P.A.J.M.B.), Ghent University Hospital, Belgium; Division of Neurology (E.M.), CHU of Grenoble, Grenoble Institute of Neurosciences, Grenoble Alpes University, France; and Department of Neurology (C.B.), Inselspital, University of Bern, Switzerland.
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Anna Sauerbier
From the Department of Clinical Neurosciences (G.D.L., G.B.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Department of Neurosciences and Mental Health (Neurology) (V.C.), Hospital Santa Maria-CHLN, and Centro de Estudos Egas Moniz (V.C.), Faculdade de Medicina, Universidade de Lisboa, Portugal; Department of Health Sciences (L.C.), Clinical Neurology Unit, ASST Santi Paolo & Carlo, Milan, Italy; Department of Neurology (A. Sauerbier), Faculty of Medicine and University Hospital Cologne, University of Cologne; Department of Neurology (L.K.), Technical University Dresden, Germany; University Hospital of Neurological Disorders (N.V.), Sechenov First Moscow State Medical University, Russia; European Academy of Neurology (L.P., A. Sander), Head Office, Vienna, Austria; Department of Neurology (M.d.V.), Academic Medical Center, Amsterdam, the Netherlands; Department of Neurology (P.A.J.M.B.), Ghent University Hospital, Belgium; Division of Neurology (E.M.), CHU of Grenoble, Grenoble Institute of Neurosciences, Grenoble Alpes University, France; and Department of Neurology (C.B.), Inselspital, University of Bern, Switzerland.
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Lisa Klingelhoefer
From the Department of Clinical Neurosciences (G.D.L., G.B.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Department of Neurosciences and Mental Health (Neurology) (V.C.), Hospital Santa Maria-CHLN, and Centro de Estudos Egas Moniz (V.C.), Faculdade de Medicina, Universidade de Lisboa, Portugal; Department of Health Sciences (L.C.), Clinical Neurology Unit, ASST Santi Paolo & Carlo, Milan, Italy; Department of Neurology (A. Sauerbier), Faculty of Medicine and University Hospital Cologne, University of Cologne; Department of Neurology (L.K.), Technical University Dresden, Germany; University Hospital of Neurological Disorders (N.V.), Sechenov First Moscow State Medical University, Russia; European Academy of Neurology (L.P., A. Sander), Head Office, Vienna, Austria; Department of Neurology (M.d.V.), Academic Medical Center, Amsterdam, the Netherlands; Department of Neurology (P.A.J.M.B.), Ghent University Hospital, Belgium; Division of Neurology (E.M.), CHU of Grenoble, Grenoble Institute of Neurosciences, Grenoble Alpes University, France; and Department of Neurology (C.B.), Inselspital, University of Bern, Switzerland.
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Nina Vashchenko
From the Department of Clinical Neurosciences (G.D.L., G.B.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Department of Neurosciences and Mental Health (Neurology) (V.C.), Hospital Santa Maria-CHLN, and Centro de Estudos Egas Moniz (V.C.), Faculdade de Medicina, Universidade de Lisboa, Portugal; Department of Health Sciences (L.C.), Clinical Neurology Unit, ASST Santi Paolo & Carlo, Milan, Italy; Department of Neurology (A. Sauerbier), Faculty of Medicine and University Hospital Cologne, University of Cologne; Department of Neurology (L.K.), Technical University Dresden, Germany; University Hospital of Neurological Disorders (N.V.), Sechenov First Moscow State Medical University, Russia; European Academy of Neurology (L.P., A. Sander), Head Office, Vienna, Austria; Department of Neurology (M.d.V.), Academic Medical Center, Amsterdam, the Netherlands; Department of Neurology (P.A.J.M.B.), Ghent University Hospital, Belgium; Division of Neurology (E.M.), CHU of Grenoble, Grenoble Institute of Neurosciences, Grenoble Alpes University, France; and Department of Neurology (C.B.), Inselspital, University of Bern, Switzerland.
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Lucia Pavlakova
From the Department of Clinical Neurosciences (G.D.L., G.B.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Department of Neurosciences and Mental Health (Neurology) (V.C.), Hospital Santa Maria-CHLN, and Centro de Estudos Egas Moniz (V.C.), Faculdade de Medicina, Universidade de Lisboa, Portugal; Department of Health Sciences (L.C.), Clinical Neurology Unit, ASST Santi Paolo & Carlo, Milan, Italy; Department of Neurology (A. Sauerbier), Faculty of Medicine and University Hospital Cologne, University of Cologne; Department of Neurology (L.K.), Technical University Dresden, Germany; University Hospital of Neurological Disorders (N.V.), Sechenov First Moscow State Medical University, Russia; European Academy of Neurology (L.P., A. Sander), Head Office, Vienna, Austria; Department of Neurology (M.d.V.), Academic Medical Center, Amsterdam, the Netherlands; Department of Neurology (P.A.J.M.B.), Ghent University Hospital, Belgium; Division of Neurology (E.M.), CHU of Grenoble, Grenoble Institute of Neurosciences, Grenoble Alpes University, France; and Department of Neurology (C.B.), Inselspital, University of Bern, Switzerland.
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Anja Sander
From the Department of Clinical Neurosciences (G.D.L., G.B.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Department of Neurosciences and Mental Health (Neurology) (V.C.), Hospital Santa Maria-CHLN, and Centro de Estudos Egas Moniz (V.C.), Faculdade de Medicina, Universidade de Lisboa, Portugal; Department of Health Sciences (L.C.), Clinical Neurology Unit, ASST Santi Paolo & Carlo, Milan, Italy; Department of Neurology (A. Sauerbier), Faculty of Medicine and University Hospital Cologne, University of Cologne; Department of Neurology (L.K.), Technical University Dresden, Germany; University Hospital of Neurological Disorders (N.V.), Sechenov First Moscow State Medical University, Russia; European Academy of Neurology (L.P., A. Sander), Head Office, Vienna, Austria; Department of Neurology (M.d.V.), Academic Medical Center, Amsterdam, the Netherlands; Department of Neurology (P.A.J.M.B.), Ghent University Hospital, Belgium; Division of Neurology (E.M.), CHU of Grenoble, Grenoble Institute of Neurosciences, Grenoble Alpes University, France; and Department of Neurology (C.B.), Inselspital, University of Bern, Switzerland.
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Marianne de Visser
From the Department of Clinical Neurosciences (G.D.L., G.B.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Department of Neurosciences and Mental Health (Neurology) (V.C.), Hospital Santa Maria-CHLN, and Centro de Estudos Egas Moniz (V.C.), Faculdade de Medicina, Universidade de Lisboa, Portugal; Department of Health Sciences (L.C.), Clinical Neurology Unit, ASST Santi Paolo & Carlo, Milan, Italy; Department of Neurology (A. Sauerbier), Faculty of Medicine and University Hospital Cologne, University of Cologne; Department of Neurology (L.K.), Technical University Dresden, Germany; University Hospital of Neurological Disorders (N.V.), Sechenov First Moscow State Medical University, Russia; European Academy of Neurology (L.P., A. Sander), Head Office, Vienna, Austria; Department of Neurology (M.d.V.), Academic Medical Center, Amsterdam, the Netherlands; Department of Neurology (P.A.J.M.B.), Ghent University Hospital, Belgium; Division of Neurology (E.M.), CHU of Grenoble, Grenoble Institute of Neurosciences, Grenoble Alpes University, France; and Department of Neurology (C.B.), Inselspital, University of Bern, Switzerland.
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Paul A.J.M. Boon
From the Department of Clinical Neurosciences (G.D.L., G.B.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Department of Neurosciences and Mental Health (Neurology) (V.C.), Hospital Santa Maria-CHLN, and Centro de Estudos Egas Moniz (V.C.), Faculdade de Medicina, Universidade de Lisboa, Portugal; Department of Health Sciences (L.C.), Clinical Neurology Unit, ASST Santi Paolo & Carlo, Milan, Italy; Department of Neurology (A. Sauerbier), Faculty of Medicine and University Hospital Cologne, University of Cologne; Department of Neurology (L.K.), Technical University Dresden, Germany; University Hospital of Neurological Disorders (N.V.), Sechenov First Moscow State Medical University, Russia; European Academy of Neurology (L.P., A. Sander), Head Office, Vienna, Austria; Department of Neurology (M.d.V.), Academic Medical Center, Amsterdam, the Netherlands; Department of Neurology (P.A.J.M.B.), Ghent University Hospital, Belgium; Division of Neurology (E.M.), CHU of Grenoble, Grenoble Institute of Neurosciences, Grenoble Alpes University, France; and Department of Neurology (C.B.), Inselspital, University of Bern, Switzerland.
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Elena Moro
From the Department of Clinical Neurosciences (G.D.L., G.B.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Department of Neurosciences and Mental Health (Neurology) (V.C.), Hospital Santa Maria-CHLN, and Centro de Estudos Egas Moniz (V.C.), Faculdade de Medicina, Universidade de Lisboa, Portugal; Department of Health Sciences (L.C.), Clinical Neurology Unit, ASST Santi Paolo & Carlo, Milan, Italy; Department of Neurology (A. Sauerbier), Faculty of Medicine and University Hospital Cologne, University of Cologne; Department of Neurology (L.K.), Technical University Dresden, Germany; University Hospital of Neurological Disorders (N.V.), Sechenov First Moscow State Medical University, Russia; European Academy of Neurology (L.P., A. Sander), Head Office, Vienna, Austria; Department of Neurology (M.d.V.), Academic Medical Center, Amsterdam, the Netherlands; Department of Neurology (P.A.J.M.B.), Ghent University Hospital, Belgium; Division of Neurology (E.M.), CHU of Grenoble, Grenoble Institute of Neurosciences, Grenoble Alpes University, France; and Department of Neurology (C.B.), Inselspital, University of Bern, Switzerland.
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Claudio Bassetti
From the Department of Clinical Neurosciences (G.D.L., G.B.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Department of Neurosciences and Mental Health (Neurology) (V.C.), Hospital Santa Maria-CHLN, and Centro de Estudos Egas Moniz (V.C.), Faculdade de Medicina, Universidade de Lisboa, Portugal; Department of Health Sciences (L.C.), Clinical Neurology Unit, ASST Santi Paolo & Carlo, Milan, Italy; Department of Neurology (A. Sauerbier), Faculty of Medicine and University Hospital Cologne, University of Cologne; Department of Neurology (L.K.), Technical University Dresden, Germany; University Hospital of Neurological Disorders (N.V.), Sechenov First Moscow State Medical University, Russia; European Academy of Neurology (L.P., A. Sander), Head Office, Vienna, Austria; Department of Neurology (M.d.V.), Academic Medical Center, Amsterdam, the Netherlands; Department of Neurology (P.A.J.M.B.), Ghent University Hospital, Belgium; Division of Neurology (E.M.), CHU of Grenoble, Grenoble Institute of Neurosciences, Grenoble Alpes University, France; and Department of Neurology (C.B.), Inselspital, University of Bern, Switzerland.
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Citation
Education Research: Impact of Burnout on Neurology Residents and Research Fellows in Europe
Giovanni Di Liberto, Giuseppina Baldizzi, Vanessa Carvalho, Luca Cuffaro, Anna Sauerbier, Lisa Klingelhoefer, Nina Vashchenko, Lucia Pavlakova, Anja Sander, Marianne de Visser, Paul A.J.M. Boon, Elena Moro, Claudio Bassetti
Neurol Edu Dec 2022, 1 (2) e200035; DOI: 10.1212/NE9.0000000000200035

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Abstract

Background and Objectives To investigate the prevalence of burnout profiles and their contributing factors in European neurology residents, junior neurologists, and research fellows.

Methods The members of the Resident and Research Fellow Section (RRFS) of the European Academy of Neurology were surveyed using standardized instruments for burnout, job satisfaction, social support, depression, work-related fatigue, work-life integration, and impact of life events, from September 1, 2020, to January 6, 2021.

Results The response rate was 23.1% (332 responders of 1,439 contacted RRFS members); the median age of participants 30 years, with 61.5% being female. Our analysis revealed that 73.9% of the responders showed a perturbation in the Maslach Burnout Inventory dimensions, thus fulfilling the criteria for a dysfunctional phenotype within the burnout spectrum: burnout (22.6%), overextended (26.1%), ineffective (21.0%), and disengaged (4.1%). Multivariate logistic regression analysis indicated that elevated number of night shifts per month, work-related fatigue, and low professional satisfaction are independent risk factors for burnout. Being a certified neurologist, working in an academic environment, and a higher job satisfaction are associated with the engaged profile, a productive state characterized by high energy, strong involvement, and a sense of efficacy.

Discussion Burnout experience is highly prevalent among neurology residents, junior neurologists, and research fellows in Europe. The profile-based approach in this survey captures the multifaceted nature of burnout experience, therefore highlighting mitigating strategies that can be tailored to the distinct dysfunctional burnout profile.

Glossary

3D-WFI=
Three-Dimensional Work Fatigue Inventory;
COVID-19=
coronavirus disease 2019;
EAN=
European Academy of Neurology;
JSS=
Job Satisfaction Survey;
LCI=
Life Change Index Scale;
MBI=
Maslach Burnout Inventory;
MBI-HSS=
MBI-Human Services Survey;
MSPSS=
Multidimensional Scale of Perceived Social Support;
PHQ-9=
Patient Health Questionnaire-9;
RRFS=
Resident and Research Fellow Section;
WSAS=
Work and Social Adjustment Scale

Footnotes

  • ↵* These authors contributed equally to this work as co-first authors.

  • Go to Neurology.org/NE for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Submitted and externally peer reviewed. The handling editor was Roy Strowd III, MD, MEd, MS.

  • Received June 2, 2022.
  • Accepted in final form October 26, 2022.
  • © 2022 American Academy of Neurology

This is an open access article distributed under the terms of the Creative Commons Attribution License 4.0 (CC BY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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