Burnout in Canadian urology: Cohort analysis from the 2018 Canadian Urological Association census

Introduction: Physician burnout is associated with medical error, patient dissatisfaction, and poorer physician health. Urologists have reported high levels of burnout and poor work-life integration compared with other physicians. Burnout rates among Canadian urologists has not been previously investigated. We aimed to establish the prevalence of Canadian urologist burnout and associated factors. Methods: In the 2018 Canadian Urological Association census, the Maslach Burnout Inventory questions were assigned to all respondents. Responses from 105 practicing urologists were weighted by region and age group to represent 609 urologists in Canada. Burnout was defined as scoring high on the scales of emotional exhaustion or depersonalization. Demographic and practice variables were assessed to establish factors associated with burnout. Comparisons were made to the results of the 2016 American Urological Association census. Results: Overall, 31.8% of respondents met the criteria for burnout. There was no effect of subspecialty practice or practice setting on burnout. On univariate analysis, rates of burnout were highest among urologists under financial strain (50.8%), female urologists (45.3%), and early-to-mid-career urologists (37.7–41.8%). Factors associated with demanding practices and poor work-life integration were predictive of burnout. A total of 12.2% of urologists reported seeking burnout resources and 54.0% wished there were better resources available. Conclusions: Urologist burnout in Canada is lower than reported in other countries, but contributing factors are similar. Urologists who report demanding clinical practices (particularly in early-to-mid career), poor work-life integration, financial strain, and female gender may benefit from directed intervention for prevention and management of burnout. Burnout resources for Canadian urologists require further development.