Structured Weekly Reflection to Support Well-being in Neuroradiology Fellowship: A Pilot Study

Burnout among neuroradiologists is substantial, yet burnout in neuroradiology fellows remains understudied, and evidence-based, low-burden well-being interventions targeting subspecialty fellows remain scarce.

This prospective, single-arm study enrolled all 9 neuroradiology fellows at a single academic medical center during the 2025-2026 academic year. Participants received 12 weekly structured reflection prompts via plain-text email aligned to the construct domains of the Oldenburg Burnout Inventory (OLBI) targeting exhaustion, disengagement, or professional efficacy. Fellows completed reflections privately; responses were not collected. Burnout was assessed using the validated OLBI at baseline (week 0, January 2026 approximately 6 months into the fellowship year) and post-intervention (week 12, April 2026). Secondary outcomes included self-reported well-being change and program acceptability. Wilcoxon signed-rank tests compared pre/post scores.

All 9 fellows completed both surveys. Six of 9 (67%) completed 10-12 of 12 reflections; 8 of 9 (89%) spent 10 min or less per prompt. Mean total OLBI score decreased from 2.04 to 1.90, with reductions in exhaustion (-0.19) and disengagement (-0.10); changes did not reach statistical significance. All fellows endorsed the intervention as a good use of time and supported its incorporation into the fellowship curriculum. The most commonly endorsed benefit was the opportunity to pause and reflect (9/9).

A 12-week structured reflection program was feasible and well-accepted in a neuroradiology fellowship. Directional improvements in burnout scores alongside high acceptability suggest this approach warrants further evaluation in larger cohorts.