Factors Associated With the Mental Health and Satisfaction of Oral and Maxillofacial Surgery Residents in the United States: A Cross-Sectional Study and Analysis

Pediatric dentistry, prosthodontics, and oral and maxillofacial surgery residents' stress, career satisfaction, and gender-based discrimination/harassment

OBJECTIVES

Dental residents experience high stress in their demanding programs and gender-based harassment/discrimination can contribute to their stress. The objectives were to compare stress, satisfaction, experienced sexual harassment and observed discrimination of women in dental graduate programs with high, medium, and low percentages of women and to explore relationships between these constructs of interest.

METHODS

Note that, 112 pediatric dentistry (PD), 44 prosthodontics, and 56 oral and maxillofacial surgery (OMS) residents responded to a survey.

RESULTS

PD residents had the lowest personal life-related stress (4-point scale with 4 = very stressful: PD = 2.99/P = 3.67/OMS = 3.56; p < 0.001), faculty-related stress (2.68/3.66/3.03; p < 0.001), lack of confidence-related stress (2.79/3.31/2.96; p < 0.01) and academic stress (2.65/3.24/3.02; p < 0.001), while prosthodontics residents had the highest stress levels. The average frequency of experiencing sexual harassment was highest for OMS residents and lowest for PD residents (5-point scale with 1 = never: 1.15/2.62/2.74; p < 0.001). PD residents observed least and OMS residents most frequently that female residents were treated less positively by other residents because of their gender (1.59/2.57/3.00; p < 0.001). Prosthodontics residents had the lowest job satisfaction score (5-point scale with 1 = lowest satisfaction: 4.12/3.14/4.20; p < 0.001). The more frequently male and female residents experienced sexual harassment, the higher their personal life-related stress, faculty-related stress, lack of confidence-related stress, and academic stress, and the lower their career satisfaction, specialty content satisfaction, and stress-related satisfaction. Women's frequencies of observed gender-based discrimination were associated with higher stress and lower satisfaction, while men's frequencies of these observations were not associated with stress, but associated with increased satisfaction.

CONCLUSIONS

Dental residents' stress, career satisfaction, experienced sexual harassment, and observed discrimination of women residents differ depending on the dental specialty program. Both male and female residents report more stress and less satisfaction the more they experience sexual harassment. The more women observe discrimination of women, the more stressed and the less satisfied they are. For men, the frequencies of these observations are not associated with stress, but positively associated with increased satisfaction.

Resident Burnout and Well-being in Otolaryngology and Other Surgical Specialties: Strategies for Change

OBJECTIVE

To perform a literature review on burnout prevalence, factors that affect burnout and well-being, and solutions to address burnout in otolaryngology-head and neck surgery (OTO-HNS) residents and residents in other surgical specialties.

DATA SOURCES

Ovid Medline, Embase, and article reference lists.

REVIEW METHODS

A literature search was performed to identify articles on resident burnout, distress, wellness, well-being, and quality of life. Articles deemed outside the scope of the current work were excluded. Search was limited to the past 5 years.

CONCLUSIONS

Moderate to high burnout has been reported in 35% to 86% of OTO-HNS residents. Among other surgical specialties, resident burnout ranges between 58% and 66% in plastics, 11% and 67% in neurosurgery, 38% and 68% in urology, and 31% and 56% in orthopedics. Highest burnout rates were seen in postgraduate year 2 residents. Factors significantly associated with burnout included hours worked (>80 h/wk), level of autonomy, exercise, and program support. Reported resident work hours have steadily increased: 8% of OTO-HNS residents in 2005 vs 26% in 2019 reported averaging >80 h/wk. Practical implications of resident burnout include decreased empathy, moral distress and injury, poor health, decreased quality of life, increased attrition, decreased desire to pursue fellowship, and increased likelihood of medical errors. Structured mentorship programs, wellness initiatives, and increased ancillary support have been associated with lower burnout rates and improvements in resident well-being across specialties.

IMPLICATIONS FOR PRACTICE

Addressing burnout, which is prevalent in OTO-HNS residents, is critical to improving patient care and physician well-being. Surgical specialties can share strategies to effectively address resident burnout through institutional interventions, which can be essential quality improvement initiatives, to promote well-being.

Personality traits and risk of posttraumatic stress disorder among dental residents during COVID-19 crisis

PURPOSE/OBJECTIVES

The coronavirus disease 2019 (COVID-19) pandemic has presented mental health challenges among healthcare professionals, including posttraumatic stress disorder (PTSD). Few studies have examined PTSD predictors in dental settings. This cross-sectional study aimed to describe the relationship between personality traits and PTSD symptoms among US dental residents engaged in patient care during the pandemic.

METHODS

An online survey was administered to residents in advanced education in general dentistry, dental anesthesia, general practice residency, oral and maxillofacial surgery, and pediatric dentistry programs between September 2020 and April 2021. The survey included a sociodemographic questionnaire, the Big Five Inventory, and the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Logistic regression models, analysis of variance, and Tukey tests were used to examine the association between variables and PTSD scores and assess differences in personality traits and PTSD by specialty.

RESULTS

Among 149 respondents (mean age = 29.9 ± 4.9 years; 57.0% female), 53.7% reported experiencing stress during the pandemic. Many residents (38.9%) were not aware of available mental health resources. A total of 17.4% of residents met the diagnostic criteria for PTSD, but only 1.3% reported a previous PTSD diagnosis. The most significant predictors of PTSD were neuroticism (odds ratio = 2.90, p = 0.046) and stress unrelated to the resident's program role during the pandemic (odds ratio = 5.88, p = 0.02).

CONCLUSIONS

PTSD symptoms were highly prevalent among dental residents, with stress and neuroticism being the most significant predictors.

Work-Life Balance for Oral and Maxillofacial Surgeons

Oral and maxillofacial surgeons experience high levels of stress and work-home conflict, which predispose them to burnout. There is emerging evidence in support of work-life integration to prevent burnout; interventional strategies exist on an individual and organizational level. This article explores the current evidence on promoting work-life integration for improved surgeon satisfaction, performance, and efficiency. Work-life integration initiatives can help promote the recruitment and retention of a diverse surgical workforce in oral and maxillofacial surgery.

What is the Resident Perception of Physician Assistants in an Oral and Maxillofacial Training Program?

PURPOSE

Physician assistants (PAs) are not employed in a widespread manner in the academic oral and maxillofacial surgery setting despite being able to assist with resident workload. We aim to measure residents' perception of PAs employed by an academic oral and maxillofacial surgery department after the addition of 2 PAs to the department.

METHODS

The investigators conducted an anonymous cross-sectional survey study addressing resident perception of PA's on reducing their working hours, the scope of PA's role, and the positive and negatives of working with a PA. The survey was distributed to current oral and maxillofacial surgery residents, non-categorical interns, and recent graduates at Parkland Memorial Hospital and John Peter Smith Hospital between November 1, 2020 and January 31, 2021. A follow-up survey to collect demographic data was distributed between May 20, 2021 and June 10, 2021. Descriptive statistics were used to summarize the results, with bootstrapping techniques to calculate 95% confidence intervals (CI).

RESULTS

Investigators contacted 54 residents and recent alumni, and 31 (57%) responded to the original survey and 32 responded to the follow-up survey. All respondents agreed that the addition of PAs decreased resident workload (100%; 95% CI). The majority stated PAs should assist with rounding on inpatients (61%; 95% CI), in hospital consultations (52%; 95% CI), clinic appointments (74%; 95% CI), and patient care coordination (97%; 95% CI). Only 29% (95% CI) stated that PAs should be assisting in the operating room.

CONCLUSION

The results of this study suggest that residents perceive the addition of PAs to the academic oral and maxillofacial surgery program to be beneficial when it comes to reducing overall workload and increasing potential educational opportunities, by assisting with care coordination, outpatient appointments, and inpatient rounding.

Factors Influencing Residents' Psychological Status During Standardized Training in COVID-19

Objectives: To explore the influencing factors of residents' psychological status during standardized training in COVID-19 for finding ways to promote their mental health. Methods: A total of 760 residents were surveyed with a structured questionnaire. Correlation analysis was used to analyze the influencing factors of psychological status of the residents, and a mediation model was constructed to verify the mediating role of satisfaction. Results: Age, willingness to study medicine, and satisfaction were positively correlated with negative psychological status (P < 0.05). And gender, only child or not, and annual household income (RMB) were negatively correlated with negative psychological status (P < 0.01). Residents' satisfaction with standardized training mode plays a complete mediating role between annual household income and negative psychological status. Conclusions: Our findings emphasize the importance of concentrating on resident's psychological status and family economic situation. And relative departments should take action to optimize the standardized training mode to improve the satisfaction.