Burnout among physicians, including pediatricians, is increasingly recognized as a prevalent condition in need of urgent action. In this issue of Pediatrics, Weiss et al present cross-sectional survey data showing that over 50% of pediatric subspecialty fellows at their freestanding, tertiary care children’s hospital report burnout (10.1542/peds.2021-050393). This percentage is similar to the percentage of pediatric residents who report burnout. Clearly, the prevalence of burnout among pediatric trainees is high, which warrants interventions at both the institutional and national levels.
Perhaps the most important initial intervention is combatting the stigmatization of burnout and need for mental health treatment. The most sobering data from the study is that the majority of the fellows believed that their program directors, supervising faculty, and patients would view them less favorably if they knew the fellow had a mental health condition. Most fellows also reported that they would hide their mental health treatment, likely due to fear of stigmatization and potential negative effects on employment and patient trust. Many institutions are working on ways to address burnout among trainees, faculty, and staff. The study by Weiss et al shows that a critical first step is to de-stigmatize burnout and the need for mental health treatment. In their conclusions, the authors provide several ideas to normalize and model help-seeking behaviors and self-care. These efforts need to start with individuals in positions of power – department chairs, program directors, hospital leadership. Creating a culture from the top down that openly discusses burnout and mental health, and that supports individuals to seek treatment, can help create a safe environment for trainees to access the care that they need.