Bullying, Discrimination, Sexual Harassment, and Physical Violence: Common and Associated With Burnout in Pediatric Residents

  • Kathi J Kemper
    Address correspondence to Kathi J Kemper, MD, MPH, College of Medicine, the Ohio State University, 370 W 9th Ave Columbus, OH 43210
    Department of Pediatrics (KJ Kemper), College of Medicine, the Ohio State University, Columbus, Ohio
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  • Alan Schwartz
    Departments of Medical Education and Pediatrics (A Schwartz), University of Illinois College of Medicine, Chicago, Ill
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  • on behalf of the?>Pediatric Resident Burnout-Resilience Study Consortium
Published:February 27, 2020DOI:



      Many pediatric residents suffer from burnout. We aimed to describe the prevalence, source, and epidemiology of bullying, discrimination, harassment, and physical violence, and the relationship between these experiences and burnout.


      We analyzed data from the Spring, 2019 Pediatric Resident Burnout and Resilience Study Consortium's 72-item online survey. Surveys included screening questions about burnout; residents’ characteristics and experiences, and attitudes about their learning environment.


      Nineteen hundred fifty-six residents (66% of those eligible) from 46 programs participated; most (70%) were women and most (66%) were Caucasian. Overall 45% reported weekly or more frequent burnout symptoms; 33% reported 1 or more of these experiences (“mistreatment”) during the past year: 19% reported experiencing bullying; 18% reported discrimination; 5% reported sexual harassment; and 1% reported physical violence. The most frequent sources of mistreatment were clinical staff (60%), patients’ families (54%), and faculty (43%). Women were more likely than men to report mistreatment (36% vs 25%, P < .01) Residents who reported experiencing mistreatment were more likely than those who did not to report symptoms of burnout (adjusted odds ratio 1.98; 95% confidence interval, CI 1.62–2.42); they also reported higher stress levels, lower quality of life, and were less likely to agree that their program prioritized collaboration, education, or mentoring (P < .001 for all).


      Mistreatment occurs frequently among pediatric residents, especially women; mistreatment is associated with burnout, stress, lower quality of life, and worse attitudes about the learning environment. Future studies could explore whether institutional efforts to improve workplace civility improves resident well-being and attitudes about training.


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