Well-Being, Burnout, and Resiliency Among Early-Career Rheumatologists

A Qualitative Study

Bharat Kumar, MD, MME, FACP, RhMSUS; Melissa L. Swee, MD, MME; Manish Suneja, MD; Priyanka Iyer, MD, MPH


J Clin Rheumatol. 2021;27(8):e404-e411. 

In This Article

Abstract and Introduction


Background/Objective: Physician well-being is being increasingly recognized for its important role in high-quality patient care, integrity of the healthcare system, and vitality of the workforce. However, little is known about well-being, resiliency, and burnout among rheumatologists, particularly early-career rheumatologists. In this qualitative study, the investigators explore these concepts among early-career rheumatologists.

Methods: We performed a qualitative study using semistructured phone interviews of rheumatologists who completed fellowship in 2017. Participants were recruited through purposive sampling. Twenty questions were devised by the investigators, covering sample demographics, exploring definitions of well-being, resiliency, and burnout, and probing potential solutions.

Interviews were recorded and transcribed independently and verified for consistency. The investigators used grounded theory to code the transcripts and iteratively derive categories, subthemes, and themes until reaching theoretical sufficiency.

Results: Sixty-four rheumatologists were interviewed, accounting for 30.6 hours of material. Seven major themes were identified: (1) well-being as a holistic state where an individual is able to translate one's potential to maximal performance, (2) work-family balance as a dynamic equilibrium changing over time, (3) inadequacy of training in addressing self-doubt over autonomy, (4) uncertainty over career development and progression, (5) excessive administrative burdens, (6) protective nature of longitudinal relationships, and (7) addressing burnout requires a multifaceted approach at multiple levels.

Conclusions: New rheumatologists face a series of challenges as they enter the workforce. Investments into well-being can help reduce the risk of burnout and enlarge our community. Our results highlight drivers and potential solutions, as identified by recent fellowship graduates.


Physician well-being is increasingly being recognized for its important role in maintaining high-quality patient care, integrity of the healthcare system, and vitality of the physician workforce.[1] However, studies suggest that nearly half of healthcare practitioners have symptoms of burnout, an occupational syndrome characterized by a poor sense of well-being accompanied by emotional exhaustion, depersonalization, and lack of personal satisfaction.[2]

Little is known about well-being and burnout among rheumatologists, particularly early-career rheumatologists who are transitioning from fellowship to independent practice. The 2018 Medscape Physician Burnout and Depression report indicated that 38% of rheumatologists were burnt out, roughly in line with the rate of burnout among all physicians. However, the factors contributing to burnout remain unexamined.[3] To fill this gap in knowledge, we pursued a qualitative investigation to better understand the drivers of well-being and burnout as well as potential strategies to maintain well-being and mitigate burnout.