Well-being of nephrology fellows: Evolution over the course of a pandemic year

Background: We sought to assess changes in well-being of nephrology fellows over the first year of the COVID-19 pandemic in the U.S. Methods: The Resident Well-Being Index (RWBI), a validated tool assessing physician distress, was distributed as part of ASN's annual nephrology fellow survey to 920 current adult, pediatric, and adult/pediatric fellows. An RWBI ≥5 (range 0-7) indicated distress. Demographic and fellowship factors associated with meeting the distress threshold were evaluated in univariable and multivariable logistic regression. Results: A total of 511 fellows participated (56% response), of whom 463 completed the RWBI instrument. After 1 year of the COVID-19 pandemic, there were a higher proportion of nephrology fellows meeting the RWBI distress threshold-22% in 2021 versus 15% in 2020. Female nephrology fellows had higher RWBI scores (median 3 [IQR 5]) than their male colleagues (median 1 [IQR 3]). Higher proportions of 1st-year fellows (50% vs 42% for 2nd years, OR 0.61 for 2nd years [95% CI 037-0.99], p=0.046) and women (27% vs 18% of men, OR 1.71 [95%CI 1.06-2.76], p=0.028) met the distress threshold (Figure 1). There were no significant differences by race, ethnicity, medical school location, or adult vs pediatric fellowship. Despite the higher proportion of distress overall, 88% of respondents would recommend nephrology to medical students and residents. Conclusions: Our follow-up assessment of nephrology fellows' well-being after the first year of the COVID-19 pandemic indicate the continued need for supportive measures to ensure the health of the future nephrology workforce, especially among 1st year and women trainees. (Figure Presented).