Burnout and endoscopy-specific workload among gastroenterologists and gastroenterology fellows in Türkiye: A national cross-sectional survey

Table 1 Demographic and professional characteristics of respondents

Characteristic	n/N (%)
Age group
< 30 years	2/278 (0.7)
30-40 years	136/278 (48.9)
41-50 years	112/278 (40.3)
51 years or older	28/278 (10.1)
Sex
Female	80/278 (28.8)
Male	196/278 (70.5)
Prefer not to say	2/278 (0.7)
Married	230/278 (82.7)
Dependents requiring care, one or more	224/278 (80.6)
Professional status
Gastroenterology fellows	82/278 (29.5)
Specialists completing obligatory service	42/278 (15.1)
Specialists who completed obligatory service	92/278 (33.1)
Academic faculty	62/278 (22.3)
Public sector practice	246/278 (88.5)
Clinical focus
General gastroenterology	148/278 (53.2)
Mixed practice	92/278 (33.1)
Other or subspecialty-focused practice	38/278 (13.7)

Percentages were calculated using the available denominator for each variable. For all variables shown in this table, the denominator was 278. “Dependents requiring care” indicates the presence of at least one dependent requiring care. Clinical focus categories are mutually exclusive. “Other or subspecialty-focused practice” includes advanced endoscopy, inflammatory bowel disease, hepatology, or other focused practice areas.

Table 2 Endoscopy workload and organisational support indicators

Parameter	n/N (%)
Weekly working hours more than 80 hours	64/276 (23.2)
Monthly on-call shifts, six or more	154/276 (55.8)
Weekly endoscopy volume more than 60 procedures/week	130/278 (46.8)
Weekly endoscopy sessions, six or more half-day units	168/278 (60.4)
Endoscopy list overruns at least once weekly	150/274 (54.7)
Emergency/unscheduled procedures, 10% or more of endoscopy workload	120/274 (43.8)
Out-of-hours endoscopy duty	70/276 (25.4)
Endoscopy days physically exhausting	194/272 (71.3)
Frequent/very frequent after-hours work communication	200/278 (71.9)
Work-life conflict	210/278 (75.5)
Insufficient post-work energy for personal or family activities	220/278 (79.1)
Inadequate endoscopy unit staff support	150/278 (54.0)
Reported access to institutional psychological support	6/278 (2.2)

Denominators vary because of item-level missingness. Endoscopy sessions refer to half-day endoscopy units. Endoscopy list overruns indicate lists exceeding scheduled time at least once weekly. Emergency or unscheduled procedures refer to respondents reporting that these procedures constituted 10% or more of their total endoscopy workload. Institutional psychological support refers to respondents’ perceived access to psychological support through their institution.

Table 3 Copenhagen Burnout Inventory scores by professional status and practice setting

Group	n	Personal burnout, median (IQR)	Work-related burnout, median (IQR)	Patient-related burnout, median (IQR)
All respondents	278	71 (59-83)	70 (57-82)	64 (50-76)
Gastroenterology fellows	82	72 (60-84)	68 (55-80)	65 (50-78)
Specialists completing obligatory service	42	68 (54-80)	68 (54-80)	60 (46-72)
Specialists who completed obligatory service	92	70 (58-82)	70 (56-82)	62 (48-74)
Academic faculty	62	74 (62-86)	74 (60-86)a	68 (52-80)
Public sector	246	74 (62-86)b	72 (58-84)b	66 (52-78)b
Non-public practice	32	58 (46-70)	60 (48-72)	52 (40-64)
CBI score of 50 or higher, n/N (%)	-	221/278 (79.5)	217/278 (78.1)	194/278 (69.8)

^aP = 0.04 for the post-hoc comparison of work-related burnout between academic faculty and gastroenterology fellows.

^bP < 0.001 for public sector vs non-public practice for the corresponding Copenhagen Burnout Inventory domain. The threshold-based burnout row was not included in the group comparisons shown in this table.

Copenhagen Burnout Inventory (CBI) subscale scores are presented as median (interquartile range) and were transformed to a 0-100 scale, with higher scores indicating greater burnout. The threshold-based burnout row presents the proportion of respondents with CBI subscale scores of 50 or higher and should not be interpreted as an unbiased national prevalence estimate. Rows for professional status and practice setting represent separate stratifications. CBI: Copenhagen Burnout Inventory; IQR: Interquartile range.

Table 4 Spearman correlations between workload variables and Copenhagen Burnout Inventory subscale scores

Variable	Personal burnout	Work-related burnout	Patient-related burnout
Monthly on-call frequency	0.72	0.68	0.55
Weekly endoscopy volume	0.65	0.70	0.60
Endoscopy list overrun frequency	0.61	0.66	0.71
After-hours work communication frequency	0.59	0.64	0.52
Weekly working hours	0.58	0.62	0.48
Perceived staff support	-0.55	-0.60	-0.49
Work-life balance	-0.68	-0.74	-0.56

Values represent Spearman’s rank correlation coefficients. Positive coefficients indicate higher burnout scores with increasing workload or burden. Negative coefficients for perceived staff support and work-life balance indicate lower burnout scores among respondents reporting more favourable organisational conditions. All correlations were statistically significant at P < 0.001.