Study finds higher levels of burnout among LGBTQ+ physicians and residents

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Researchers from Boston University Chobanian & Avedisian School of Medicine and Boston Medical Center (BMC) conducted a first-of-its-kind multicenter study on the relationship between sexual and gender minority (SGM) status and occupational well-being in physicians and residents. The study, published in the Journal of the American Medical Association (JAMA), proved an association between SGM status and well-being, with physicians and residents who identified as lesbian, gay, bisexual, transgender and queer (LGBTQ+) reporting increased burnout and decreased professional fulfillment, while also being likelier to leave their current practice, compared with their non-LGBTQ+ peers.

Over recent years, burnout has been increasingly prevalent, a public health crisis affecting both physicians and the patients they serve. Health care professionals who identify as SGM and LGBTQ+ undoubtedly experience unique workplace stressors. However, the potential relationship between SGM status and occupational well-being in physicians and residents has been left relatively unexplored.

“Our study highlights that LGBTQ+ physicians experience more burnout, less professional fulfillment and greater intent to leave their practice than non-LGBTQ+ physicians,” said Carl G. Streed, MD, MPH, FACP, FAHA, corresponding author of the study, associate professor of medicine at the school and a primary care physician at BMC. “Given the scarcity of LGBTQ+ physicians and the increasing prevalence of patients who identify as LGBTQ+, a disproportionate loss of LGBTQ+ physicians will negatively impact our profession’s capacity to meet patients’ need for high-quality, accessible health care.”

Researchers conducted a cross-sectional survey of attending physicians and trainees from October 2019 to July 2021, across 8 academic medical institutions. Questions were intended to assess the prevalence of burnout, professional fulfillment, intent to leave their current position, anxiety and depression among those with self-reported SGM status.

The group collected responses from 8,376 attending physicians and 2,564 trainees. Of those responses, 386 physicians (4.6%) and 212 trainees (8.3%) identified as SGM/LGBTQ+. Attending physicians who identified as SGM had a decreased prevalence of professional fulfillment, at 34.5%, compared with their non-SGM peers, at 40.4%. Of responding SGM attending physicians, 47.4% reported feelings of burnout and 33.2% intended to leave their current positions, compared with non-SGM attending physicians, of which 35.4% reported burnout and 30.9% had intent to leave their positions. SGM trainees similarly felt less professional fulfillment and felt more burnt out than their non-SGM peers.

According to the researchers, a health care workforce in which clinicians resemble the communities they serve is essential to improving overall health and well-being. “Given the importance of LGBTQ+ physicians in providing essential skills and sharing lived experience with many of our patients, it is important to understand the factors that affect their recruitment and retention,” Susannah G. Rowe, MD, MPH, FACS, co-author of the study, associate CMO for wellness and professional vitality at BMC and assistant professor of ophthalmology at the school, explained in a university release.

The authors emphasized the significance of the study, and the importance of further research into the individual, community and institutional factors affecting the well-being and success of LGBTQ+ physicians and residents.

“An understanding of the occupational well-being of physicians is incomplete if it does not include SGM status,” the authors of the study wrote. “Making the experience of SGM physicians and trainees visible will allow interventions to be deployed that improve their well-being and retention. With the inclusion of SGM identity in surveys of physicians and trainees [among other factors] … researchers would be able to conduct more thoughtful intersectional analyses, including those with multiple minority identities. Additionally, with more surveys inclusive of SGM status, specialty-specific issues could be explored.”