Repeated Cross-sectional Surveys of Burnout, Distress, and Depression among Anesthesiology Residents and First-year Graduates

Calcium and vitamin D supplements and burnout of anesthesiologists: National cross-sectional study from China

OBJECTIVE

Job burnout among anesthesiologists has been consistently high. This study evaluated the association of calcium and vitamin D supplementation with burnout among Chinese anesthesiologists.

METHOD

A cross-sectional online survey was conducted during April and May 2023. Burnout was evaluated using the Maslach Burnout Inventory, which assesses emotional exhaustion, depersonalization, and low personal accomplishment. Data on calcium and vitamin D supplementations were self-reported. Sociodemographic information and medical history were also assessed. Binary and ordinal logistic regression were used to evaluate the risk of burnout and burnout levels, respectively. The relative excess risk due to interaction and the attributable proportion due to interaction were examined to determine the synergistic effects of calcium and vitamin D supplementations on burnout risk.

RESULTS

Among the 4222 invited anesthesiologists, 3766 submitted eligible questionnaires. Approximately 49.8% met the criteria for general burnout. Among anesthesiologists with burnout, 58.4% experienced emotional exhaustion, 35.8% depersonalization, and 61.2% low personal accomplishment. Anesthesiologists receiving calcium supplementation had a decreased risk of emotional exhaustion (OR = .83, 95% CI = .70-.99). Supplementation of vitamin D with or without calcium was not associated with overall burnout and any of its dimensions. No additive interaction of calcium and vitamin D on burnout was observed.

CONCLUSIONS

Job burnout among anesthesiologists is of concern in China. Burnout is negatively associated with calcium supplementation but not with vitamin D. Further research is warranted to confirm the mechanism and causal relationship.

Burnout and its determinants among anaesthesia care providers in Switzerland: a multicentre cross-sectional study

The escalating epidemic of burnout in healthcare professionals affects provider well-being, patient care and sustainability of healthcare systems. The objective of this study was to determine the prevalence of burnout among anaesthesia care providers (consultants, trainees or nurse anaesthetists) in Switzerland and identify risk factors to develop strategies for prevention. This multicentre cross-sectional study was conducted at 22 anaesthesia departments in the German-speaking part of Switzerland, using an online questionnaire. Burnout assessment was performed using the Maslach Burnout Inventory. Additionally, the questionnaire included questions on workplace and personal risk factors. Of 1630 anaesthesia care providers contacted, 688 (42%) completed the survey. Among respondents who specified their work positions (n = 676), 52% (149/287) of nurses and 59% (229/389) of physicians were at high risk of burnout; and 9% (26/287) of nurses and 18% (70/389) of physicians met the criteria for burnout syndrome. Logistic regression analysis found significant associations between burnout and perceived lack of support at work among physicians (odds ratio (95%CI) 2.66 (1.40-5.24), p = 0.004); being a trainee in the 1st and 2nd year of training (2.91 (1.14-7.41), p = 0.024); being a trainee with > 5 years of experience (2.78 (1.08-6.98), p = 0.031); and male gender among nurses (4.13 (1.62-11.2), p = 0.004) and physicians (2.32 (1.22-4.47), p = 0.011). Work-related errors due to high workload or fatigue were reported by 65% (444/688) and consideration of leaving the profession due to working conditions was expressed by 46% (319/688) of respondents. Anaesthetic care providers in German-speaking Switzerland experience a considerable prevalence of burnout, influenced mainly by workplace factors.

Comparing characteristics and perspectives of U.S. anesthesiology fellows in training and anesthesiologists in their first year of practice

BACKGROUND

The purpose of this study was to evaluate relationships between demographics, professional characteristics, and perceived challenges facing the specialty of anesthesiology among physicians who entered a fellowship and those who started independent practice immediately after finishing a U.S. anesthesiology residency.

METHODS

Anesthesiologists in the year after their residency graduation were invited to take an online survey during the academic years of 2016-2017, 2017-2018, and 2018-2019, with questions about their personal characteristics, the nature of their professional lives, and their perceptions of the greatest challenge facing the profession of anesthesiology.

RESULTS

A total of 884 fellows-in-training and 735 anesthesiologists starting independent practice right after the completion of their residency responded. Fellows were slightly younger (mean = 33.2 vs. 34.0 years old, p < 0.001), were more likely to have a spouse who works outside the home (63.9% vs. 57.0%, p = 0.002), had fewer children (mean = 0.69 vs. 0.88, p < 0.001), worked more hours per week (mean = 56.2 vs. 52.4, p < 0.001), and were less likely to report a personal and professional life balance (66.4% vs. 72.3% positive, p = 0.005) than direct-entry anesthesiologists. Fellows and direct-entry anesthesiologists identified similar challenges in three broad themes - workforce competition (80.3% and 71.8%), healthcare system changes (30.0% and 37.9%), and personal challenges (6.4% and 8.8%). Employment security issues posed by non-physician anesthesia providers and perceived lack of appreciation of anesthesiologists' value were commonly cited. Relative weighting of challenge concerns varied between fellows and direct-entry physicians, as well as within these groups based on gender, fellowship subspecialty, location or size of practice, and frequency of supervisory roles.

CONCLUSIONS

Anesthesiology fellows and direct-entry anesthesiologists had largely similar demographics and perspectives on the challenges facing anesthesiology in the United States. Group differences found in some demographics and perspectives may reflect different motivations for choosing their professional paths and their diverse professional experiences.

Family Anesthesia Experience: Improving Social Support of Residents Through Education of Their Family and Friends

Introduction

The prevalence of burnout among anesthesiology residents is 41%-51%. Burnout is associated with medical errors, physician turnover, and substance use disorder. Social support and wellness may reduce burnout, but a barrier is support persons' lack of understanding of an anesthesiologist's work demands. We developed the Family Anesthesia Experience (FAX) to help support persons best support their resident.

Methods

FAX consisted of a 4-hour event with hands-on experience, didactics portion, and panel discussion. Participants learned about a typical day in the life of an anesthesiology resident, wellness, burnout, substance use disorder, and available support resources, and had hands-on experience with procedures. The panel discussion offered logistical information about anesthesiology residency and allowed support persons to ask panel members questions. A postevent survey collected feedback on the event.

Results

Fifty-one participants (first-year anesthesiology residents and their support persons) attended the event. Eight of 11 residents (73%) and 32 of 40 support persons (80%) completed the survey. All enjoyed the event, would recommend it to other anesthesiology resident support persons, and felt the event would improve communication and support. Most learned a moderate (35%) to large amount (50%) from the event. Qualitative feedback suggested most support persons found the event helpful in improving their understanding of anesthesiology residents' work demands.

Discussion

The FAX was well liked by participants. Although we did not assess specific knowledge gained and long-term effects of the 2022 event, evaluations of previous years' events suggest that the event improved participants' understanding of anesthesiology residents' work and stressors.

Patient Safety and Clinician Well-Being

Clinician well-being and patient safety are intricately linked. We propose that organizational factors (ie, elements of the perioperative work environment and culture) affect both, as opposed to a bidirectional causal relationship. Threats to patient safety and clinician well-being include clinician mental health issues, negative work environments, poor teamwork and communication, and staffing shortages. Opportunities to mitigate these threats include the normalization of mental health care, peer support, psychological safety, just culture, teamwork and communication training, and creative staffing approaches.

Career decisions, training priorities, and perceived challenges for anesthesiology residents in the United States

STUDY OBJECTIVE

This study sought to understand the timing and important factors identified by residents regarding their decision to pursue a career in anesthesiology, training areas deemed important to their future success, perceived greatest challenges facing the profession of anesthesiology, and their post-residency plans.

DESIGN

The American Board of Anesthesiology administered voluntary, anonymous, repeated cross-sectional surveys to residents who began clinical anesthesia training in the U.S. from 2013 to 2016 and were subsequently followed up yearly until the completion of their residency. The analyses included data from 12 surveys (4 cohorts from clinical anesthesia years 1 to 3), including multiple-choice questions, rankings, Likert scales, and free text responses. Free responses were analyzed using an iterative inductive coding process to determine the main themes.

MAIN RESULTS

The overall response rate was 36% (6480 responses to 17,793 invitations). Forty-five percent of residents chose anesthesiology during the 3rd year of medical school. "Nature of the clinical practice of anesthesiology" was the most important factor influencing their decision (average ranking of 5.93 out of 8 factors, 1 [least important] to 8 [most important]), followed by "ability to use pharmacology to acutely manipulate physiology" (5.75) and "favorable lifestyle" (5.22). "Practice management" and "political advocacy for anesthesiologists" (average rating 4.46 and 4.42, respectively, on a scale of 1 [very unimportant] to 5 [very important]) were considered the most important non-traditional training areas, followed by "anesthesiologists as leaders of the perioperative surgical home" (4.32), "structure and financing of the healthcare system" (4.27), and "principles of quality improvement" (4.26). Three out of 5 residents desired to pursue a fellowship; pain medicine, pediatric anesthesiology, and cardiac anesthesiology were the most popular choices, each accounting for approximately 20% of prospective fellows. Perceived greatest challenges facing the profession of anesthesiology included workforce competition from non-physician anesthesia providers and lack of advocacy for anesthesiologist values (referenced by 96% of respondents), changes and uncertainty in healthcare systems (30%), and personal challenges such as psychological well-being (3%).

CONCLUSIONS

Most residents identified anesthesiology as their career choice during medical school. Interest in non-traditional subjects and fellowship training was common. Competition from non-physician providers, healthcare system changes, and compromised psychological well-being were perceived concerns.

The relationship between physician burnout and depression, anxiety, suicidality and substance abuse: A mixed methods systematic review

Introduction

The World Health Organization defines burnout as a problem associated with employment, a category distinct from psychological disorders such as depression, anxiety, suicidality and disorders of substance abuse. Evaluating the association between burnout as an occupational exposure and psychological morbidity may indicate that burnout can act as an occupational risk factor for mental ill-health. The systematic review explores this relationship in physicians due to the increased risk in this population and the implications for healthcare delivery.

Methods

A mixed methods systematic review of the literature was conducted across Medline, Cinahl Plus, PsycInfo, Web of Science and The Cochrane Library. Databases were systematically searched using keywords relating to physician burnout and depression, anxiety, suicidality and substance abuse. Identified articles were screened for eligibility by two independent researchers. Data extraction was performed and studies assessed for risk of bias. Quantitative and qualitative results were integrated using a convergent segregated approach and results portrayed as a narrative synthesis.

Results

Sixty-one articles were included in the review. There was notable heterogeneity in the measurement and criteria used to define burnout limiting the assimilation of results. Despite this, all studies that measured the association between depression and burnout reported a significant association. Studies that reported association between burnout and anxiety were similarly uniformly consistent. Most studies that reported the association between burnout and suicidality indicated that a significant association exists however difficulty in measurement of suicidality may have influenced variability of results. The reported association between substance abuse and burnout was more variable, suggesting that any association is likely to be weak or influenced by other variables. Qualitative studies described the manifestations of chronic workplace stress as well as perceived links with psychological morbidity. These included lack of time for work-life balance, the contribution of professional relationships and a culture of invulnerability that exists among physicians.

Conclusion

The systematic review cannot conclude causality but suggests that physician burnout is associated with depression, anxiety and suicidality. Qualitative data provides insight into the nature of this association. The review indicates the need for longitudinal research and provides considerations for intervention strategies to prevent the development and progression of burnout.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020172938, identifier: CRD42020172938.

Cross-sectional survey of sleep, fatigue and mental health in veterinary anaesthesia personnel

OBJECTIVE

To evaluate the sleep quality, prevalence of fatigue and depressive symptoms in veterinary anaesthesia personnel.

STUDY DESIGN

Anonymous online voluntary survey.

METHODS

Sleep quality, fatigue, depressive symptoms and self-perceived burnout were scored using the Pittsburgh Sleep Quality Index (PSQI), Fatigue Severity Scale (FSS), Patient Health Questionnaire-9 (PHQ-9) and single-item burnout measure, respectively. Demographic data and questions about work-related fatigue, out-of-hours duty, transport and rest periods were included. PSQI, FSS and PHQ-9 scores were compared using Spearman rank correlation tests.

RESULTS

Responses from 393 participants were obtained from an estimated population of 1374 including diplomates of the American and European Colleges of Veterinary An(a)esthesia and Analgesia (43.9%), residency-trained veterinarians (15.6%), residents-in-training (13.8%) and veterinary technicians and nurses (12.0%), from 32 countries. Most were employed in clinical university teaching hospitals (54.2%) or clinical private practice (41.5%). PSQI scores > 5 were reported by 71.2% of respondents, with 52.4% reporting insufficient sleep to meet their job demands. Many showed high or borderline fatigue (56.4%), and 74.7% reported mistakes due to work-related fatigue. Major depressive symptoms (PHQ-9 score ≥ 10) were found in 42.7%, with 19.2% reporting they had thought about suicide or self-harm in the previous 2 weeks. Over half (54.8%) met the criteria for burnout and more veterinary nurses and technicians suffered from burnout than other roles, with 79.6% of this group affected (p < 0.001). Scores for PSQI and FSS [r (388) = 0.40, p < 0.001]; PSQI and PHQ-9 [r (389) = 0.23, p < 0.001]; and FSS and PHQ-9 [r (387) = 0.24, p < 0.001] were all positively correlated.

CONCLUSIONS AND CLINICAL RELEVANCE

This survey demonstrates a high prevalence of poor sleep, fatigue, depressive symptoms and burnout in veterinary anaesthesia personnel, and more should be done to improve the health of those in the profession.

Training satisfaction and well-being among veterinary anaesthesia residents: time for action

OBJECTIVE

To explore the satisfaction and well-being experienced by anaesthesia residents during their training, and to investigate factors that may have influenced their experiences.

STUDY DESIGN

Cross-sectional online anonymous voluntary survey.

SAMPLE POPULATION

A total of 150 (of approximately 600 canvassed) former veterinary anaesthesia residents.

METHODS

Participants were invited to complete an internet-based survey regarding the satisfaction and well-being experienced during their residency. Multiple choice, categorical, dichotomous, Likert-type rating scales and slider questions were used to investigate five domains (demographic, working conditions, educational environment, training satisfaction, well-being). Sampling adequacy, questionnaire reliability and participant responses were investigated by Kaiser-Meyer-Olkin (KMO) indices, Cronbach's α and standard statistical techniques, respectively (p < 0.05).

RESULTS

The questionnaire demonstrated good sampling adequacy (median KMO index 0.74; range 0.51-0.89) and high item 'reliability' (α = 0.82-0.94). Of the 150 responders, (25% participation rate) 62% were satisfied, 14% were neutral and 24% were dissatisfied with their residency training; 60.6% would do the residency again, 39.3% would not or were unsure. Sex and age did not correlate with training satisfaction (p > 0.05). Salary/stipend was considered inadequate by 70% of responders; 66% received no on-call supplement. Greater supervisory input, a good working environment and extra income when on-call were positively correlated with training satisfaction (p < 0.01). The majority (94.6%) of trainees suffered from at least one medical condition during their residency, with fatigue, sleep disturbance or anxiety reported by > 62%.

CONCLUSIONS

Although a quarter of responders were dissatisfied with their residency, several modifiable factors were identified, particularly with respect to supervisors' input, working environment and pay, which could inform improvements for future residency programmes. Most trainees experienced negative health impacts; however, this parallels the general situation in both the medical and veterinary professions, which requires greater attention from the supervisors, trainees and colleges.

Evaluation of psychological impact of COVID-19 on anesthesiology residents in the United States

The aim of our study was to evaluate the impact of COVID-19 on the mental health of in-training anesthesiology residents in the United States. A link containing validated survey tools including the Depression-Anxiety-Stress-Scale (DASS-21), the Abbreviated Maslach Burnout Inventory (aMBI), and the Brief Resilient Coping Scale (BRCS) along with questions related to work environment, and additional personal factors were emailed to 159 Anesthesiology residency programs across the US. 143 responses were received of which 111 were complete. The prevalence of depression, anxiety, stress and burnout was 42%, 24%, 31% and 71% respectively. Emotional exhaustion, depersonalization, and reduced feelings of personal accomplishment were experienced by 80%, 53%, and 65% of respondents, respectively. The BRCS scale showed 33% of respondents with low, 44% with moderate and 22% with high coping scales. Logistic regression analyses indicated those with a prior mental health diagnosis were 3 times more likely to have a non-normal DASS depression score, 4 times more likely to have a non-normal DASS anxiety score, and 11.74 times more prone to emotional exhaustion. Increased work hours and higher training levels were associated with increased levels of stress. In our survey, prior mental health illness, gender and increased work hours were the main drivers of increased risk .

Psychological Distress after the COVID-19 Pandemic among Anesthesiologists in Poland—An Observational Study

Introduction: The response to the COVID-19 pandemic by anesthesiologists has been simply heroic. Unfortunately, there are very few evidence-based studies in the literature that focus on anesthesiologists’ burnout during that time. The purpose of our study was to examine the psychological distress, after the COVID-19 pandemic, among anesthesiologists in Poland. Methods: We conducted an anonymous internet survey among a group of anesthesiologists in Poland. It contained a questionnaire, entitled “Oldenburg Burnout Inventory (OLBI)”, with demographic questions about sex, age, and family, as well as questions related to working conditions during the COVID-19 pandemic. We received data from 158 people, including 109 women and 49 men. Results: Results from the analysis showed that 73% (115/158) of the participants suffered from burnout. Moreover, 95.6% of the participants thought that the COVID-19 pandemic had had an influence on their level of burnout, and 97.3% found that it had had a negative impact. Conclusions: There is no doubt that healthcare workers, despite the difficulties associated with their daily work, have not faced challenges on such a scale in a very long time. Support for their mental health should be an essential component of the modern public healthcare system.

A Qualitative Study Exploring the Support Needs of Newly Qualified Nurses and their Experiences of an Online Peer Support Intervention

BACKGROUND

In the transitional period following registration, newly qualified nurses may feel socially isolated and easily overwhelmed by increases in accountability, workplace pressures and the psychological demands of the role. Such experiences place them at risk of burnout and leaving the profession.

AIMS

To explore newly qualified nurses' support needs and their experiences of an online peer support intervention.

METHOD

Eighteen newly qualified nurses participated in online peer support groups. After 3 months participants took part in interviews exploring their support needs and experiences of the groups. Eight one-to one interviews were conducted between October 2019 and January 2020. Qualitative thematic analysis was used.

FINDINGS

Two themes identified were; "The Support needs of newly qualified nurses" with two subthemes, "The role of the newly qualified nurse" and "Unmet support needs"; "The online experience" with three subthemes, "Barriers to participation", "Anticipated benefits" and "Unmet expectations".

CONCLUSION

Our findings suggested that there is insufficient support for newly qualified nurses. The newly qualified nurses wanted to use online support to help manage their stress. However, the organisation of online peer support needs careful consideration to ensure participation can be beneficial.

IMPACT STATEMENT

Online support requires careful design and clear support from employing organisations to promote improved transition experiences. Further research should focus on evaluating adjusted online support interventions.

Occupational Stress among Operation Room Clinicians at Ethiopian University Hospitals

Background. The surgical operation room is a known stressor workplace. Occupational stress can cause negative impacts on the personal well-being of healthcare professionals, health services, and patient care. Since there was limited research evidence in Ethiopia and the developing world, we aimed to determine the prevalence and factors associated with occupational stress among operation room clinicians at university hospitals in Northwest Ethiopia, 2021. Methodology. After ethical approval was obtained, a cross-sectional census was conducted from May 10 to June 10, 2021. The United Kingdom Health and Safety Executive’s Management Standards Work-Related Stress Indicator Tool was used to assess occupational stress. Data were collected from 388 operation room clinicians and analysed by using binary logistic regression analysis. Results. The prevalence of occupational stress was 78.4%. Rotating work shifts (AOR: 2.1, CI: 1.1–4.7), working more than 80 hours per week (AOR: 3.3, CI: 1.5–3.8), use of recreational substances (AOR: 2.1, CI: 1.1–3.8), being an anesthetist (AOR: 4.1, CI: 1.7–10.0), and being a nurse (AOR: 4.0, CI: 1.7–9.7) were found significantly associated with occupational stress. Conclusion. We found that there was high prevalence of occupational stress among operation room clinicians and factors associated with occupational stress were rotating work shifts, working more than 80 hours per week, use of recreational substances, being an anesthetist, and being a nurse. Hospitals are advised to arrange occupational health services for operation room clinicians, prepare sustainable training focused on occupational health, and reorganize shifts, working hours, and staffing.

It Takes a Village: A Narrative Review of Anesthesiology Mentorship

Mentorships play a critical role in the development of physician careers and should be tailored within a structured, evidence-based mentoring program to ensure mutual benefit and avoidance of pitfalls. We offer a narrative review of the current literature and commentary on mentoring at the medical student, GME trainee, and early career faculty levels within anesthesiology, and propose a framework on which an effective mentoring program can be implemented.

A Perspective on Wellness in Anesthesiology Residency Programs: A Multi-Strategy Approach

Addressing resident wellness is an important topic given the high risk for burnout and depression in resident physicians compared with the general U.S. population. This article provides an overview of various approaches to help conceptualize and intervene on resident wellness, based on the 9-strategies framework to improve wellness laid out by Shanafelt and colleagues. This article outlines the most relevant literature in each strategy followed by the authors' experience within their anesthesiology residency program.

Trauma-Informed Care in the Classroom: Our Experience with a Content Warning in a Medical School Course

Trauma is now recognized as a common human experience that has consequences, including adverse effects on learning outcomes. Principles of trauma-informed care include awareness of the impact of trauma and use of strategies to prevent retraumatization. While well-described in medical and mental health care, these principles have been inconsistently applied in the medical education classroom. Content warnings can be part of a trauma-informed classroom approach that notifies learners about potentially distressing topics, allows individuals to employ self-care, and seeks to resist retraumatization. This article describes our experience integrating a content warning about reproductive topics in a second-year medical school course.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40670-022-01559-0.

Early-Career Physician Burnout

Early-career physicians face a broad range of challenges unique to their phase of life and career. Beginning in residency, anesthesiologists encounter stressors unique to their work environment, which, when coupled with their personal life demands, places significant burden and creates potential for burnout. In this article, the authors review the literature to explore the contributors of burnout in early-career anesthesiologists, evaluate the relationship between compassionate care and empathic distress, and propose strategies to prevent and treat burnout in this specific subset of anesthesiologists.

Burnout in anaesthesiology residents: A systematic review of its prevalence and stressors

BACKGROUND

Burnout is an occupational hazard precipitated by chronic exposure to excessive work-related stress. It can have negative impacts on the health and safety of patients and clinicians. Anaesthesiologists are at a high risk of burnout; anaesthetic residents especially may experience higher levels of stress as a result of training requirements and postgraduate examinations. However, the scale of burnout among anaesthesiology residents is not well evaluated.

OBJECTIVES

To determine the prevalence of burnout and identify risk factors contributing to it among anaesthesiology residents worldwide and evaluate preventive strategies at institutional and departmental levels.

DESIGN

A systematic review without meta-analysis.

DATA SOURCES

We searched PubMed, Embase, Scopus and PsycInfo for English language articles published up to 24 May 2021.

ELIGIBILITY CRITERIA

The inclusion criteria for qualitative analysis were a reported burnout prevalence in anaesthesiology residents and the use of an assessment tool. Exclusion criteria were reviews/meta-analyses/correspondence, non-English articles, articles without anaesthesiology residents and lacking information on burnout prevalence and metrics for assessment.

RESULTS

Twelve studies met the inclusion criteria; seven studies utilised the 22-item Maslach Burnout Inventory Human Services Survey (MBI-HSS) and five utilised the abbreviated Maslach Burnout Inventory (aMBI). The reported burnout prevalence among anaesthesiology residents varied between 2.7 and 67.0% (median = 24.7%). Differences in burnout criteria contributed significantly to methodological heterogeneity. Factors predisposing to burnout included long working hours, poor workplace relationships, professional examinations and adverse clinical events. Protected rest time and restricted work hours were identified as effective strategies to prevent burnout. Other preventive strategies include mindfulness and resilience courses, as well as departmental initiatives such as exercise.

CONCLUSION

Burnout is common amongst anaesthesiology residents. Standardised tools and diagnostic criteria are needed to distinguish methodological heterogeneity from true heterogeneity in study populations. Interventions have been proposed to improve management strategies to minimise burnout anaesthesiology residents.

PROSPERO REFERENCE

CRD42019140472.

Anxiety and depression among vaccinated anesthesia and intensive care doctors during COVID-19 pandemic in United Arab Emirates: a cross-sectional study

Background

The coronavirus disease 2019 (COVID-19) pandemic had an impact on frontline healthcare workers’ (HCW) mental health as they experienced depression, anxiety, and sleep disturbances. There is a need to investigate the impact on anesthesia and intensive care doctors (ICU), especially after the rise of vaccination. Anesthesia and ICU doctors are among the frontline HCW dealing with suspected and confirmed COVID-19 patients. Their job puts them at risk of developing psychological disorders because of the daily stress. The aim of the current study was to assess factors affecting anxiety and depression among vaccinated anesthesia and ICU doctors working in United Arab Emirates (UAE). A cross-sectional study targeting vaccinated anesthesia and ICU doctors in UAE was conducted during March 2021. Data were collected using an online questionnaire uploaded to Google Forms including two sections; the first section included question assessing personal data, professional background data, previous COVID-19 diagnosis, and type of vaccine received. The second section of the questionnaire included the Hospital Anxiety and Depression Scale (HADS). Logistic regression analysis was used to assess the association of different factors with anxiety and depression. Adjusted odds ratio (AOR) and 95% confidence intervals (CI) were calculated.

Results

Significantly higher anxiety (46%) and depression (53.6%) were associated with the Pfizer–BioNTech vaccine. The lowest anxiety (23.9%) and depression (21.6%) scores were related to the Sinopharm vaccine. Anxiety was significantly higher for participants previously diagnosed with COVID-19 (AOR = 2.55), and depression was lower for those who deal with COVID-19-positive patients (AOR = 0.28). Anesthesiologists had significantly lower anxiety and depression than those specialized in both anesthesia and ICU (AOR = 0.32 and 0.51)

Conclusions

Previous diagnosis with COVID-19, female gender, and medical comorbidities were associated with high rates of symptoms of anxiety and depression among anesthesia and ICU doctors. Regular monitoring of the mental health impact of COVID-19, especially after the availability of different vaccines, is recommended.

COVID-19 Impact on Resident Mental Health and Well-Being

Columbia University's Papper Symposium, a virtual event held on March 20, 2021, was dedicated to the coronavirus disease-2019 (COVID-19) pandemic. This article summarizes a lecture by Dr. Roberta Hines, Nicholas M. Greene Professor of Anesthesiology and Department Chair and Chief of Anesthesiology at Yale-New Haven Hospital titled "The impact of COVID-19 on trainees: lessons learned and unanticipated opportunities," in addition draws from experiences at Columbia University Irving Medical Center and a focused review of the literature on the toll of the pandemic on trainee well-being and mental health. Early research has demonstrated that rates of burnout and acute stress were higher among health care providers who cared for COVID-19 patients than those who did not and that COVID-19 frontline health care providers are at high risk for common psychological disorders, including depression, anxiety, and post-traumatic stress disorder. Trainees working on the frontlines may be at particularly high risk for these mental health disorders and are less likely to access resources available to them. Program directors and hospital graduate medical education leaders should be aware of the threats to physiological and psychological safety and take action to prevent further detrimental effects. The rates of burnout and mental health disorders among trainees are expected to rise as a result of the pandemic, making screening programs and increased access to mental health treatment an essential feature of all residency and fellowship programs.

Graduate medical education in anaesthesiology and COVID-19: lessons learned from a global pandemic

PURPOSE OF REVIEW

The recent global pandemic has dramatically altered the anaesthesiology educational landscape in unexpected ways. It is important that we pause to learn from this crisis.

RECENT FINDINGS

Most resident trainees actively caring for COVID-19 patients present with probable or subclinical finding of post-traumatic stress disorder. Anaesthesia resident training programmes evolved to continue the mission of anaesthesia education in the face of institutional restrictions and evolving clinical crises.

SUMMARY

The recent global COVID-19 pandemic has illustrated how external stressors can cause significant disruption to traditional medical education pathways. Resilience to external disruptive forces in anaesthesia education include a willingness of leadership to understand the problem, flexibility in adapting to the needs of learners and instructors in the face of key challenges, deployment of technology and innovation-minded solution-finding where appropriate, and attention to Maslow's hierarchy of needs.

VIDEO ABSTRACT

http://links.lww.com/COAN/A77.

Patient safety education in anesthesia: current state and future directions

PURPOSE OF REVIEW

Although patient safety is a core component of education in anesthesiology, approaches to implementation of education programs are less well defined. The goal of this review is to describe the current state of education in anesthesia patient safety and the ideal patient safety curriculum.

RECENT FINDINGS

Anesthesiology has been a pioneer in patient safety for decades, with efforts amongst national organizations, such as the American Society of Anesthesiologists and the Anesthesia Patient Safety Foundation to disseminate key standards and guidelines in patient safety. However, few, if any strategies for implementation of a patient safety curriculum in anesthesiology exist.

SUMMARY

Patient safety education is crucial to the field of anesthesiology, particularly with the advancement of surgical and anesthesia technologies and increasing complexity of patients and procedures. The ideal patient safety curriculum in anesthesiology consists of simulation, adverse event investigation and analysis, and participation in process improvement. Efforts in education must adapt with changing technology, shifts in the way anesthesia care is delivered, and threats to physician wellness. Future efforts in education should harness emerging platforms, such as social media, podcasts, and wikis.

A Coronavirus Disease 2019 Pandemic Pivot: Development of the American Board of Anesthesiology's Virtual APPLIED Examination

In 2020, the coronavirus disease 2019 (COVID-19) pandemic interrupted the administration of the APPLIED Examination, the final part of the American Board of Anesthesiology (ABA) staged examination system for initial certification. In response, the ABA developed, piloted, and implemented an Internet-based "virtual" form of the examination to allow administration of both components of the APPLIED Exam (Standardized Oral Examination and Objective Structured Clinical Examination) when it was impractical and unsafe for candidates and examiners to travel and have in-person interactions. This article describes the development of the ABA virtual APPLIED Examination, including its rationale, examination format, technology infrastructure, candidate communication, and examiner training. Although the logistics are formidable, we report a methodology for successfully introducing a large-scale, high-stakes, 2-element, remote examination that replicates previously validated assessments.

A Positive Depression Screen Is Associated with Emergency Medicine Resident Burnout and Is not Affected by the Implementation of a Wellness Curriculum

Introduction

While burnout is occupation-specific, depression affects individuals comprehensively. Research on interventions for depression in emergency medicine (EM) residents is limited.

Objectives

We sought to obtain longitudinal data on positive depression screens in EM residents, assess their association with burnout, and determine whether implementation of a wellness curriculum affected the rate of positive screens.

Methods

In February 2017, we administered the Maslach Burnout Inventory and the Primary Care Evaluation of Mental Disorders Patient Health Questionnaire two-question depression screen at 10 EM residencies. At five intervention sites, a year-long wellness curriculum was then introduced while five control sites agreed not to introduce new wellness initiatives during the study period. Study instruments were re-administered in August 2017 and February 2018.

Results

Of 382 residents, 285 participated in February 2017; 40% screened positive for depression. In August 2017, 247/386 residents participated; 27.9% screened positive for depression. In February 2018, 228/386 residents participated; 36.2% screened positive. A positive depression screen was associated with higher burnout. There were similar rates of positive screens at the intervention and control sites.

Conclusion

Rates of positive depression screens in EM residents ranged between 27.9% and 40%. Residents with a positive screen reported higher levels of burnout. Rates of a positive screen were unaffected by introduction of a wellness curriculum.

US Residents' Perspectives on the Introduction, Conduct, and Value of American Board of Anesthesiology's Objective Structured Clinical Examination-Results of the 1st Nationwide Questionnaire Survey

Introduction:

Passing the Objective Structured Clinical Examination (OSCE) is currently a requirement for the vast majority (not all) of candidates to gain American Board of Anesthesiology (ABA) initial certification. Many publications from the ABA have attempted to justify its introduction, conduct and value. However, the ABA has never attempted to understand the views of the residents.

Methods:

A total of 4237 residents at various training levels from 132 programs were surveyed by asking to fill a Google questionnaire prospectively between March 8th, 2021 and April 10th, 2021. Every potential participant was sent an original email followed by 2 reminders.

Results:

The overall response rate was 17.26% (710 responses to 4112 invitations). On a 5-point Likert scale with 1 as “very inaccurate” and 5 as “very accurate,” the mean accuracy of objective structured clinical examination (OSCE) in assessing communication skills and professionalism was 2.3 and 2.1 respectively. In terms of the usefulness of OSCE training for improving physicians' clinical practice, avoiding lawsuits, teaching effective communication with patients and teaching effective communication with other providers, the means on a 5-point Likert scale with 1 as “Not at all useful” and 5 as “Very useful” were 1.86, 1.69, 1.79, and 1.82 respectively. Residents unanimously thought that factors such as culture, race/ethnicity, religion and language adversely influence the assessment of communication skills. On a 5-point Likert scale with 1 as “not at all affected” and 5 as “very affected,” the corresponding scores were 3.45, 3.19, 3.89, and 3.18 respectively. Interestingly, nationality and political affiliation were also thought to influence this assessment, however, to a lesser extent. In addition, residents believed it is inappropriate to test non-cardiac anesthesiologists for TEE skills (2.39), but felt it was appropriate to test non-regional anesthesiologists in Ultrasound skills (3.29). Lastly, nearly 80% of the residents think that money was the primary motivating factor behind ABA's introduction of the OSCE. Over 96% residents think that OSCE should be stalled, either permanently scrapped (60.8%) or paused (35.8%).

Conclusions:

Anesthesiology residents in the United States overwhelmingly indicated that the OSCE does not serve any useful purpose and should be immediately halted.

Depression, Healthcare Utilization, Missed Work, and Health Behaviors Among US Young Workers: Data From the 2015 National Health Interview Survey

OBJECTIVE

We examined the prevalence of depression and its impact on healthcare utilization, work absenteeism, and health behaviors among United States (US) young workers.

METHODS

Data of 1053 young workers (ages 18 to 25) from the 2015 US National Health Interview Survey were analyzed to examine these associations.

RESULTS

Seven percent of US young workers reported feeling often depressed (daily or weekly). Often depressed young workers had increased odds for healthcare provider visits, mental healthcare use, 1 to 2 emergency department visits, and 3 to 5 and more than or equal to 6 missed work days, smoking, and sleeping less than 7 hours.

CONCLUSIONS

Our findings suggest that depressed young workers have increased needs for healthcare utilization and are at increased risk for missing work, smoking, and reduced sleep. Resources should be prioritized for depression screening and prevention programs at the workplace and healthcare settings.

The impact of a smartphone meditation application on anesthesia trainee well-being

STUDY OBJECTIVE

Physician burnout is a pervasive problem in the United States. The goal of this study was to investigate use of the smartphone meditation application Headspace® as a well-being improvement tool in anesthesia trainees.

DESIGN

Prospective self-controlled observational study.

SETTING

Anesthesia training program in an academic hospital.

SUBJECTS

Resident and fellow trainees in the Department of Anesthesiology and Perioperative Medicine at the University of Pittsburgh Medical Center.

INTERVENTIONS

Resident and fellow trainees were given a free 1-year subscription to the mindfulness application. Participation was voluntary and included questionnaires at baseline, 1 month, and 4 months for assessment of burnout and well-being. Questionnaires were linked with the use of de-identified codes and completed via REDCap. Questionnaires included the abbreviated Maslach Burnout Inventory, Becks Depression Index, Cohens Stress Score, Pittsburgh Sleep Quality Index, and a Headspace® Self-Reporting Questionnaire.

MEASUREMENTS

Depression, stress, sleep quality, emotional exhaustion, depersonalization, and personal achievement.

MAIN RESULTS

Of 112 trainees eligible to participate, 71 completed baseline questionnaires, 54 created application accounts, and 29 completed the entire questionnaire protocol with 4 months of app use. Application use was associated with reduced depression scores and increased feelings of personal achievement at both 1 month (p = 0.003, p = 0.066) and 4 months (p = 0.011, p = 0.005). Burnout from feelings of depersonalization and emotional exhaustion did not improve with application use. Over the study period, trainees completed 786 meditation sessions, accounting for 6123 min of app engagement.

CONCLUSIONS

Findings of decreased depression scores and improved feelings of personal achievement suggest that Headspace® could serve as a mindfulness tool for incorporating meditation into the daily practice of anesthesia trainees in an effort to improve well-being.

Training Characteristics, Personal Factors and Coping Strategies Associated with Burnout in Junior Doctors: A Multi-Center Study

Physician burnout has been recognized as a public health crisis. However, there is a paucity of burnout studies in the context of medical internship. We assessed the prevalence and relationship between various training characteristics, personal variables, resilience, and coping with burnout in a cross-sectional study involving 837 interns from ten hospitals across Malaysian healthcare system. The instrument package included demographic questions, the Connor-Davidson Resilience Scale, Brief COPE and the Copenhagen Burnout Inventory. A total of 754 (90.1%) interns completed the inventories. We found a high prevalence of personal-related (73.3%), work-related (69.1%), and patient-related (43.4%) burnout among Malaysian interns. Multivariable analysis showed female gender (odds ratio (OR):1.50; 95% confidence interval (CI): 1.02-2.20), prior work experience (OR: 1.56; 95% CI: 1.05-2.30), and irregular spirituality routines (OR: 1.97; 95% CI: 1.30-2.99) were associated with increased odds of personal-related burnout. Irregular spirituality routines (OR: 2.24; 95% CI: 1.49-3.37) were associated with work-related burnout, while living with other people (OR: 1.77; 95% CI: 1.15-2.73) was associated with patient-related burnout. Lower resilience levels and avoidant copings were associated with personal-, work-, and patient-related burnout. Burnout prevalence among interns is high. The findings support the value of individual-targeted alongside organizational-targeted intervention in burnout reduction. As burnout is prevalent in both years of internship training, ongoing burnout prevention and wellbeing measures are deemed necessary.

Burnout Rate and Risk Factors among Anesthesiologists in the United States

BACKGROUND

Physician burnout, widespread across medicine, is linked to poorer physician quality of life and reduced quality of care. Data on prevalence of and risk factors for burnout among anesthesiologists are limited. The objective of the current study was to improve understanding of burnout in anesthesiologists, identify workplace and personal factors associated with burnout among anesthesiologists, and quantify their strength of association.

METHODS

During March 2020, the authors surveyed member anesthesiologists of the American Society of Anesthesiologists. Burnout was assessed using the Maslach Burnout Inventory Human Services Survey. Additional survey questions queried workplace and personal factors. The primary research question was to assess rates of high risk for burnout (scores of at least 27 on the emotional exhaustion subscale and/or at least 10 on the depersonalization subscale of the Maslach Burnout Inventory Human Services Survey) and burnout syndrome (demonstrating all three burnout dimensions, consistent with the World Health Organization definition). The secondary research question was to identify associated risk factors.

RESULTS

Of 28,677 anesthesiologists contacted, 13.6% (3,898) completed the survey; 59.2% (2,307 of 3,898) were at high risk of burnout, and 13.8% (539 of 3,898) met criteria for burnout syndrome. On multivariable analysis, perceived lack of support at work (odds ratio, 6.7; 95% CI, 5.3 to 8.5); working greater than or equal to 40 h/week (odds ratio, 2.22; 95% CI, 1.80 to 2.75); lesbian, gay, bisexual, transgender/transsexual, queer/questioning, intersex, and asexual status (odds ratio, 2.21; 95% CI, 1.35 to 3.63); and perceived staffing shortages (odds ratio, 2.06; 95% CI, 1.76 to 2.42) were independently associated with high risk for burnout. Perceived lack of support at work (odds ratio, 10.0; 95% CI, 5.4 to 18.3) and home (odds ratio, 2.13; 95% CI, 1.69 to 2.69) were most strongly associated with burnout syndrome.

CONCLUSIONS

The prevalence of burnout among anesthesiologists is high, with workplace factors weighing heavily. The authors identified risk factors for burnout, especially perceived support in the workplace, where focused interventions may be effective in reducing burnout.

EDITOR’S PERSPECTIVE

Anesthesiology Residents' Experiences and Perspectives of Residency Training

BACKGROUND

Anesthesiology residents' experiences and perspectives about their programs may be helpful in improving training. The goals of this repeated cross-sectional survey study are to determine: (1) the most important factors residents consider in choosing an anesthesiology residency, (2) the aspects of the clinical base year that best prepare residents for anesthesia clinical training, and what could be improved, (3) whether residents are satisfied with their anesthesiology residency and what their primary struggles are, and (4) whether residents believe their residency prepares them for proficiency in the 6 Accreditation Council for Graduate Medical Education (ACGME) Core Competencies and for independent practice.

METHODS

Anesthesiologists beginning their US residency training from 2013 to 2016 were invited to participate in anonymous, confidential, and voluntary self-administered online surveys. Resident cohort was defined by clinical anesthesia year 1, such that 9 survey administrations were included in this study-3 surveys for the 2013 and 2014 cohorts (clinical anesthesia years 1-3), 2 surveys for the 2015 cohort (clinical anesthesia years 1-2), and 1 survey for the 2016 cohort (clinical anesthesia year 1).

RESULTS

The overall response rate was 36% (4707 responses to 12,929 invitations). On a 5-point Likert scale with 1 as "very unimportant" and 5 as "very important," quality of clinical experience (4.7-4.8 among the cohorts) and departmental commitment to education (4.3-4.5) were rated as the most important factors in anesthesiologists' choice of residency. Approximately 70% of first- and second-year residents agreed that their clinical base year prepared them well for anesthesiology residency, particularly clinical training experiences in critical care rotations, anesthesiology rotations, and surgery rotations/perioperative procedure management. Overall, residents were satisfied with their choice of anesthesiology specialty (4.4-4.5 on a 5-point scale among cohort-training levels) and their residency programs (4.0-4.1). The residency training experiences mostly met their expectations (3.8-4.0). Senior residents who reported any struggles highlighted academic more than interpersonal or technical difficulties. Senior residents generally agreed that the residency adequately prepared them for independent practice (4.1-4.4). Of the 6 ACGME Core Competencies, residents had the highest confidence in professionalism (4.7-4.9) and interpersonal and communication skills (4.6-4.8). Areas in residency that could be improved include the provision of an appropriate balance between education and service and allowance for sufficient time off to search and interview for a postresidency position.

CONCLUSIONS

Anesthesiology residents in the United States indicated they most value quality of clinical training experiences and are generally satisfied with their choice of specialty and residency program.

Impact of the intersection of anaesthesia and gender on burnout and mental health, illustrated by the COVID-19 pandemic

Physician burnout and poor mental health are prevalent and often stigmatised. Anaesthetists may be at particular risk and this is further increased for women anaesthetists due to biases and inequities within the specialty. However, gender-related risk factors for and experiences of burnout and poor mental health remain under-researched and under-reported. This negatively impacts individual practitioners, the anaesthesia workforce and patients and carries significant financial implications. We discuss the impact of anaesthesia and gender on burnout and mental health using the COVID-19 pandemic as an example illustrating how women and men differentially experience stressors and burnout. COVID-19 has further accentuated the gendered effects of burnout and poor mental health on anaesthetists and brought further urgency to the need to address these issues. While both personal and organisational factors contribute to burnout and poor mental health, organisational changes that recognise and acknowledge inequities are pivotal to bolster physician mental health.

Prevalence of burnout and its relationship to health status and social support in more than 1000 subspecialty anesthesiologists

BACKGROUND

Physician burnout may be at 'epidemic' proportions due to factors associated with modern healthcare practice and technology. Practice attributes vary appreciably among subspecialists. Understanding burnout incidence and its associated factors could illuminate potential causes and interventions. We evaluated burnFout, mental and physical health, and social support and coping skills in acute and chronic pain physicians and pediatric and cardiac anesthesiologists.

METHODS

We administered the Maslach Burnout Inventory Human Services Survey (MBI-HSS), a two-item self-identified burnout measure, the Veterans RAND 12-item Health Survey and the Social Support and Personal Coping Survey to subspecialty society members practicing acute and chronic pain management, pediatric anesthesiology and cardiac anesthesiology. Multivariable regression analysis compared the groups, and adjusted burnout prevalence was compared with an all-physician and an employed general population sample.

RESULTS

Among 1303 participants (response rates 21.6%-35.6% among the subspecialty groups), 43.4% met established burnout criteria (range 30.0%-62.3%). Chronic pain physicians had significantly worse scores (unadjusted) than the other three groups of subspecialty anesthesiologists, the all-physician comparator group and the general population comparator group. Mental health inversely correlated with emotional exhaustion and depersonalization in all groups. Self-identified burnout correlated with the full MBI-HSS (R=0.54; positive predictive value of 0.939 (0.917, 0.955)). Physicians' scores for personal accomplishment were higher than population norms.

CONCLUSIONS

This study provides data on burnout prevalence and associated demographic, health and social factors in subspecialist anesthesiologists. Chronic pain anesthesiologists had significantly greater burnout than the other groups. The self-identified burnout metric performed well and may be an attractive alternative to the full MBI-HSS.

Interactive anesthesiology educational program improves wellness for anesthesiologists and their children

STUDY OBJECTIVE

Anesthesiologists have a high prevalence of burnout with adverse effects on professionalism and safety. The objective of this study was to assess the impact of an interactive anesthesiology educational program on the wellness of anesthesia providers and their children, as assessed by a modified Professional Fulfillment Index.

DESIGN

Prospective observational study.

SETTING

Perioperative area.

PATIENTS

Thirty clinicians participated in the program. Twenty respondents, representing 67% of participants and each corresponding to a parent and their child or children, completed the post-event survey.

INTERVENTIONS

An interactive anesthesiology educational program incorporating children, between the ages of five and eighteen years old, of anesthesia providers was held in the perioperative area. The program was held over four hours and was comprised of four sessions including pediatric anesthesia, neuroanesthesia, airway, and ultrasound stations.

MEASUREMENTS

Anesthesia providers and their children were administered a post-event assessment, including a modified Professional Fulfillment Index and satisfaction survey.

MAIN RESULTS

All twenty (100%) of respondents indicated it was "very true" or "completely true" that their child was happy with the program, and that it was worthwhile and satisfying to both the anesthesia provider and their child. Nineteen (95%) of reporting participants indicated it was "very true" or "completely true" that it was meaningful to have the department host such a program and 17 (85%) respondents felt their child now better understands the anesthesia work of the parent. All clinician volunteers indicated it was "very true" or "completely true" that they were contributing professionally during the program in ways that they valued most.

CONCLUSION

An interactive educational wellness initiative provides an effective and feasible method for increasing professional fulfillment and satisfaction among anesthesia providers while educating our youngest generation of learners. Implementation of such a program may also occur with modifications such as televideo to maintain COVID-19 precautions.

Design and Implementation of an Innovative, Longitudinal Wellness Curriculum in an Anesthesiology Residency Program

Burnout is a serious problem that anesthesiologists face during training and in practice. To mitigate it, experts advocate for strategies focused on enhancing individual resilience in addition to organizational change in health care systems. To catalyze this change, wellness-focused education must incorporate foundational knowledge about the science of well-being and impart skills to empower trainees to lead change in the future. We developed and implemented a longitudinal, developmental 3-year curriculum in a large anesthesiology residency program that included strategies to strengthen community-building, enhance meaning from a career in medicine, and incorporated topics focused on career and leadership development.

Burnout Prevalence and Its Associated Factors among Malaysian Healthcare Workers during COVID-19 Pandemic: An Embedded Mixed-Method Study

Coronavirus disease 2019 (COVID-19) has become a global health threat and has placed an extraordinary demand on healthcare workers around the world. In this study, we aim to examine the prevalence of burnout and its associated factors and experience among Malaysian healthcare workers during the COVID-19 pandemic through an embedded mixed-method study design. We found that more than half of Malaysian healthcare workers in this sample experienced burnout. Direct involvement in COVID-19 screening or treatment, having a medical condition, and less psychological support in the workplace emerged to be the significant factors in personal-, work-, and patient-related burnout. Participants described their workloads, uncertainties caused by the pandemic, challenging work-family balance, and stretched workplace relationships as the sources of burnout. Exhaustion appeared to be the major symptom, and many participants utilized problem-focused coping to deal with the adversities experienced during the pandemic. Participants reported physical-, occupational-, psychological-, and social-related negative impacts resulting from burnout. As the pandemic trajectory is yet unknown, these findings provide early insight and guidance for possible interventions.

Well-being curriculum for anesthesiology residents: Development, processes, and preliminary outcomes

Physician burnout and healthcare worker stress are well-covered topics in both the medical and lay press. Burnout in physicians can start as early as medical school. Well-being initiatives, programming, and access to support for all medical professionals are of paramount importance. In 2014, the Accreditation Council for Graduate Medical Education (ACGME) Milestones for Resident/Fellow Education in Anesthesiology added Professionalism as a milestone. A subcategory of Professionalism includes: A responsibility to maintain personal, emotional, physical, and mental health. This subcategory charges all residency and fellowship programs with establishing a curriculum in well-being. The development, execution, and evaluation of these programs are left to the individual institutions. In this paper, the development, processes, and preliminary outcomes of a resident well-being curriculum are presented.

Occupational Stress and Mental Health among Anesthetists during the COVID-19 Pandemic

Anesthetist-intensivists who treat patients with coronavirus disease 19 (COVID-19) are exposed to significant biological and psychosocial risks. Our study investigated the occupational and health conditions of anesthesiologists in a COVID-19 hub hospital in Latium, Italy. Ninety out of a total of 155 eligible workers (59%; male 48%) participated in the cross-sectional survey. Occupational stress was assessed with the Effort Reward Imbalance (ERI) questionnaire, organizational justice with the Colquitt Scale, insomnia with the Sleep Condition Indicator (SCI), and mental health with the Goldberg Anxiety and Depression Scale (GADS). A considerable percentage of workers (71.1%) reported high work-related stress, with an imbalance between high effort and low rewards. The level of perceived organizational justice was modest. Physical activity and meditation—the behaviors most commonly adopted to increase resilience—decreased. Workers also reported insomnia (36.7%), anxiety (27.8%), and depression (51.1%). The effort made for work was significantly correlated with the presence of depressive symptoms (r = 0.396). Anesthetists need to be in good health in order to ensure optimal care for COVID-19 patients. Their state of health can be improved by providing an increase in individual resources with interventions for better work organization.