Background/Purpose: The recent ACR workforce projections suggest that there will be a significant shortage of rheumatologists by 2030. Retirement of senior physicians, an increase in part-time providers and increased demand for rheumatologic care are cited as major reasons for this shortage. This has implications for recent rheumatology fellowship graduates, who are entering this challenging environment with an eye towards building preserving well-being and bolstering resiliency. Indeed, studies demonstrate that young physicians as a whole have the lowest career satisfaction, highest frequency of personal conflicts and highest rates of depersonalization. In this qualitative study, the investigators explore the characteristics of wellness and resiliency among newly board-certified rheumatologists.

Methods: We performed a qualitative study using semi-structured phone interviews of rheumatologists who completed fellowship in 2017. Participants were recruited through purposive sampling. Eight questions were devised by the investigators, covering wellness, resiliency, and burnout and probing their perceived challenges, motivations, and opportunities for improvement.

Interviews were recorded and transcribed independently and verified for consistency. Discrepancies were resolved through mutual consensus. The two investigators used grounded theory to sequentially code the transcripts line-by-line. These codes were then compiled and organized into larger themes and subthemes. We continued to analyze these data until reaching theoretical sufficiency.

Results: 24 rheumatologists were interviewed, of which 12 were in private practice and 12 were in academic practice. Five themes were identified: (1) work-family balance as a dynamic equilibrium changing over time, (2) inadequacy of formal training in addressing self-doubt over independence and autonomy, (3) uncertainty over career development and progression, and (4) excessive burden of documentation and billing, and (5) protective nature of longitudinal patient-physician relationships. These themes overlapped in both groups, although subthemes were unique (e.g. concerns over extramural funding in academics vs. developing a patient panel in private practice).

Conclusion: New rheumatologists face a series of challenges as they enter the workforce. This qualitative study empowers participatory research to understand the needs of this unique and vulnerable population. Investments into their well-being can help reduce the risk of burnout and enlarge our community. Our results highlight priorities as identified by recent fellowship graduates and provide suggestions to training program leaders to enable successful transitions to independent practice.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/wellness-and-resiliency-among-recent-rheumatology-fellowship-graduates-a-qualitative-study/