Multi-Institutional Data for Faculty Well-Being Improvements Within and Across Medical Schools

Burnout, engagement, and satisfaction vary in prevalence and correlate with organizational performance in US medical colleges. Large-scale improvements have been elusive.

To quantify rates of well-being and its organizational correlates so to help identify opportunities for shared learning and focus well-being interventions across and within medical schools.

In this cross-sectional study, 28 US medical schools accredited by the Liaison Committee on Medical Education were surveyed from January 26, 2021, through June 3, 2024. Of 28 919 eligible faculty, 16 994 participated (58.8%; range, 21% to 92%).

The Association of American Medical Colleges' StandPoint Faculty Engagement Survey.

The psychological states of burnout, satisfaction, and organizational commitment as a proxy for engagement and their antecedents. Heterogeneity beyond chance was quantified in the rates across and within schools using the I2 statistic. Positive deviants, or bright spots, were identified as those schools and departments whose confidence intervals did not include the group mean rate. Regression analyses assessed the factors contributing to the success of the positive deviants.

Across 15 404 respondents (9093 [53.5%] identified as men), a pooled 32% reported burnout. Across schools, there was substantial heterogeneity in rates beyond chance of burnout (13%-41%; I2 = 75%), commitment (pooled 80% [range, 74%-95%]; I2 = 82%), and satisfaction (pooled 77% [range, 62%-86%]; I2 = 80%). Few departments (67 of 502 [13.3%]) had a favorable rate of both commitment and burnout. For rates of burnout at the department level, 32% of the variance was explained by the rates of burnout of their school and discipline; the rates of autonomy, purpose, and belonging; and gender and age. The burnout of individuals was explained by the mean burnout score of one's department (R2 = 4%), with no contribution by the school or discipline. When combined with the factors contributing to departmental variation, 24% of the variance in burnout across individuals was explained.

In this cross-sectional study, the substantial heterogeneity beyond chance and identification of positive deviants (bright spots) support the opportunity for learning health systems and learning communities across and within schools and professional societies to identify positive deviant departments or schools and share details of implementing existing successful practices for promoting well-being. Both burnout and engagement should be monitored within and across medical schools, as these measures may not converge.