AWARE: Anaesthesia trainee wellbeing at respective educational institutions: A national prospective study of burnout, depressive symptoms and occupational stress

Background: Anaesthesia trainees are at increased risk of burnout and depression - with occupational stress recognised as a trigger for both. Previous South African single-site studies have assessed these outcomes separately, but not within the same study. Aim: This study aimed to describe a composite mental well-being profile of South African anaesthesia trainees, focusing on burnout, depression screening, occupational stress and associated risk factors. Setting: The study was conducted among South African anaesthesia trainees from nine university-affiliated public teaching hospitals. Methods: Participants were recruited via convenience sampling through engagement with study representatives. Burnout, depression screening and occupational stress were measured using the abridged Maslach Burnout Inventory-Human Services Survey for Medical Personnel, the Harvard Department of Psychiatry National Depression Screening Day Scale and the Effort-Reward Imbalance questionnaire. The response rate was 37%. Results: Of the 194 trainees, 54 (28%) met burnout criteria, 88 (45%) screened positive for depression and 144 (74%) demonstrated chronic occupational stress. Forty-one (21%) trainees simultaneously met criteria for all three study outcomes, representing a distinctly vulnerable subcohort. Risk factors included: previous and/or current treatment for psychiatric illness, registrars in their second year of training and self-prescribing anxiolytics and antidepressants. Conclusion: Burnout rates in this population closely approximate international estimates; however, both depressive symptoms and occupational stress prevalence exceed international figures. Contribution: This first-of-its-kind study provided a composite insight into the mental well-being profile of South African anaesthesia trainees, identifying a bigger cohort at risk of burnout and/or depression in the near future.