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Introduction

The term burnout was coined in the 1970s to describe the intense stress faced by individuals in professions focused on helping others, such as doctors and nurses (Maslach and Leiter, 1976). Today, however, people recognize and study burnout across many different occupations. The World Health Organization (WHO) defines burnout as “a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed.” WHO characterizes burnout by three dimensions: (1) decreased energy or exhaustion; (2) negativity and/or cynicism toward, or feelings of distance from one’s job; and (3) feelings of reduced efficacy at work (WHO, 2019).

Though burnout has long created challenges for many workers in science, technology, mathematics, and medicine (STEMM) fields, the COVID-19 pandemic had sweeping effects on the STEMM workforce and led to increased burnout for many that has drawn greater attention to issues of burnout in recent years. Faced with health and economic uncertainty, along with workplace challenges from an ever-changing and overtaxed system, many workers in STEMM fields experienced and continue to experience heightened symptoms of burnout (Gewin, 2021; Lievens, 2021; Linzer et al., 2022). Pandemic-related strains and increased demands at home and work exacerbated long-standing gender differences in burnout (Dillon et al., 2021; NASEM, 2021). Indeed, prior to COVID-19, women experienced greater rates of burnout, as well as associated symptoms such as exhaustion, cynicism, and low feelings of efficacy (Gold et al., 2016; Jensen and Deemer, 2019; Rabatin et al., 2016). A 2021 National Academies of

Sciences, Engineering, and Medicine report on the impact of COVID-19 on the careers of women in STEMM found that the combined uneven effects of the pandemic, coupled with existing inequities in burnout, could worsen the gender gap in these fields (NASEM, 2021). Taken together, burnout is a long-standing, but recently significantly exacerbated issue with important gender implications for the STEMM workforce.

Addressing burnout is important for healthy workplaces and healthy individuals. As detailed in the workshop and this proceedings, burnout comes with many significant consequences for workers who may face physical and mental health challenges as well as organizations that can suffer from absenteeism, attrition, and diminished engagement, all of which can reduce growth and innovation. In healthcare settings, consequences have the potential to be even more dire. It has been shown that burnout can be related to negative patient outcomes as individual providers are struggling to manage overwhelming caseloads and hours. The uneven effect of burnout is also cause for concern for a thriving STEMM ecosystem, as this can diminish the kind of creativity and innovation that thrives in environments when a broad set of voices are represented. Taken together, these challenges make clear the need for continued attention to burnout and interventions in STEMM fields.

To explore these challenges in greater detail, the Committee on Women in Science, Engineering, and Medicine of the National Academies convened a workshop on October 1 and 2, 2024, in Washington, D.C., to examine burnout and its implications for gender equity in STEMM (see Box 1-1 for the Statement of Task and Appendix A for the workshop agenda). Through three commissioned papers, panel and breakout discussions, and participant engagement, the workshop was designed to examine current knowledge, share lessons learned, and consider ways to address burnout in STEMM settings. Though the committee was explicitly tasked only with looking at the implications of burnout for gender equity, in the process of planning the workshop, committee members decided to extend their attention to race as well given the ways in which issues of gender and race are deeply intwined in the workplace and broader society. Additionally, the workshop while looking broadly at STEMM gave particular attention to healthcare settings for two key reasons. First, burnout among healthcare providers is particularly acute given the challenges of exceptionally long hours, high expectations of devotion, and work with potentially challenging consequences. Second, likely as a result of the high rates of burnout in healthcare, the literature on burnout in healthcare settings is the most extensive of that in any other STEMM field.

OPENING REMARKS

Planning committee chair Reshma Jagsi (Emory University) welcomed participants in person and virtually to the workshop and thanked the National Institutes of Health Office for Research on Women’s Health for sponsoring the workshop. Representing the planning committee, she said, “We’re here to learn from many incredible speakers but also to learn from you, our audience. We spoke at length about the topics most pressing on our

minds and likely the minds of many people about what it means to grapple with being burned out at work.” The committee designed the workshop to unpack burnout, she continued—what it is, how it has been conceived and misconceived, how it comes to be, what its impacts are, and what can be done about it. “Throughout, we focus on the implications for equity,” Jagsi said. “While acknowledging that anyone can experience burnout, the implications are uneven across the population.”

As an initial way to engage all attendees and learn from their experiences, Jagsi asked them to participate in a quick online poll to share one word that comes to mind when they think of burnout. Frequent responses were “exhaustion,” “overwhelmed,” “stress,” and “isolation” (see Figure 1-1). “These are concepts that we will rely on our expert speakers to help us unpack and understand the relationships between them,” she said.

ORGANIZATION OF THIS PROCEEDINGS

The remainder of this publication summarizes the presentations and discussions from the workshop. The workshop began with a moderated discussion with two leading experts to understand burnout and challenge misconceptions about it, which is summarized in Chapter 2. Highlights from two of the commissioned papers follow, with Chapter 3 on the causes and associated risk factors and Chapter 4 on consequences of

burnout, both followed by moderated discussions. Chapter 5 summarizes a panel that took a deep dive on burnout, identity, and intersectionality. Chapter 6 highlights the third commissioned paper on current and innovative approaches to managing burnout, followed in Chapter 7 by another deep dive panel, this one on interventions to manage burnout in medicine given particular challenges of burnout in healthcare professions. The workshop concluded with interactive discussions on three interrelated topics focused on interventions to address burnout. Report-outs from these discussions and concluding comments from the workshop organizers are reported in Chapter 8. Though the workshop was designed to have Day 1 provide important context and background on burnout and Day 2 examine interventions, given the hunger among both presenters and audience members for actionable policies and practices that can mitigate burnout, questions and discussions of interventions occurred throughout the two days. The workshop agenda, biographical sketches of the speakers, and full text of the commissioned papers can be found in the appendixes.

In accordance with the policies of the National Academies, this proceedings does not attempt to establish any conclusions or recommendations about needs and future directions for research, focusing instead on key issues and themes discussed by the speakers and workshop participants. The proceedings was prepared by the workshop rapporteurs as a factual summary of what was presented and discussed at the workshop. The planning committee’s role was limited to planning and convening the workshop. The statements made are those of the rapporteurs and do not necessarily represent positions of the workshop participants as a whole, the planning committee, or the National Academies.

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