128 - Cultivating Community in Medicine: Factors Shaping Belonging and Burnout Among GME Trainees

Publication Number: 4125.128

Vivian Doyle Mason, University of North Carolina at Chapel Hill School of Medicine, Chapel hill, NC, United States; Ashmita Chatterjee, University of North Carolina at Chapel Hill School of Medicine, Raleigh, NC, United States; Kenya A. McNeal-Trice, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States

Background: Sense of belonging, the feeling of being valued and connected, is a key determinant of wellbeing and success in graduate medical education (GME) and training. While existing research has examined factors impacting the sense of belonging and wellness within certain medical specialties, there is limited understanding of how these factors intersect across different GME programs and trainee identities. There is a paucity of research on impact wellness initiatives have on trainees' sense of belonging and incidence of burnout.

Objective: To identify factors that influence sense of belonging and burnout among trainees at a large academic healthcare center.

Design/Methods: Institutional Review Board approval was obtained (ID #25-0762). All GME trainees at the University of North Carolina Hospitals were surveyed between May and June 2025. Surveys queried the sense of belonging in 3 contexts (social, academic, and institutional support), knowledge of GME wellness programs, a 7-item Maslach Burnout Inventory (MBI), and demographic information. Higher scores correlated with higher sense of belonging. MBI scores of ≥4 correlated with high burnout. Statistical significance was set at P < 0.05.

Results: Of 1,037 trainees surveyed, 251 (24%) responded. Interns endorsed lower academic belonging (p=0.010) and lower knowledge of GME wellness programs compared to more senior trainees (p=0.002). Younger trainees endorsed lower institutional support compared to older trainees (p =0.032). Racial minorities endorsed lower social (p=0.019) and lower academic belonging (p=0.029) compared to other trainees. 51% of trainees endorsed high burnout scores ≥4. Trainees in surgical specialties endorsed lower academic belonging (p=0.004) and higher burnout (p=0.03) compared to non-surgical specialties. Pediatric specialty trainees endorsed higher sense of belonging (p=0.001) and lower burnout (p=0.048) compared to non-pediatric specialties. Surgical specialty trainees endorsed lower knowledge of GME programs compared to non-surgical specialties (p=0.004); however, pediatric specialty trainees endorsed higher knowledge of GME programs (p=0.007).

Conclusion(s): Our study identified interns, younger age, minoritized groups and surgical specialties were identities associated with lower sense of belonging; surgical specialties were associated with higher burnout; and pediatric specialties were associated with higher sense of belonging and lower burnout. Further studies regarding access to wellness initiatives and programs across different specialties are needed to continue to support trainee wellbeing, burnout prevention, and sense of belonging.

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Figure 1: Association of Demographic Factors with Sense of Belonging
Demographic factors with significant differences in sense of belonging scores (scaled 1-5) among residents and fellows surveyed between May and June 2025. (Panel A) Institutional belonging associated with age of trainees (P = 0.0315). (Panel B) Academic belonging associated with Post Graduate Year of trainees (P = 0.01). (Panel C) Academic belonging associated with racial identity of trainees (P = 0.0293). (Panel D) Social belonging associated with racial identity of trainees (P = 0.0188).

Figure 2: Association of Surgical Specialty Trainees and Pediatric Specialty Trainees with Sense of Belonging, Burnout, and Awareness/Utilization of GME Wellness Program
Differences in sense of belonging scores (scaled 1-5), burnout scores (scaled 1-7), and awareness/use of GME wellness program among surgical specialty trainees, non-surgical specialty trainees, pediatric trainees and non-pediatric trainees. (Panel A) Academic belonging associated with surgical specialty vs non-surgical specialty trainees (P = 0.0004). (Panel B) Total burnout associated with surgical specialty vs non-surgical specialty trainees (P = 0.0302). (Panel C) Awareness and/or use of GME wellness program associated with surgical specialty vs non-surgical specialty trainees (P = 0.004). (Panel D) Total belonging associated with pediatric specialty vs non-pediatric specialty trainees (P = 0.001). (Panel E) Total burnout associated with pediatric specialty vs non-pediatric specialty trainees (P = 0.048). (Panel F) Awareness and/or use of GME wellness program associated with pediatric specialty vs non-pediatric specialty trainees (P = 0.007).