OBJECTIVE This cross-sectional study characterized associations between sex, role misidentification, and burnout among surgical and nonsurgical residents. SUMMARY BACKGROUND DATA Limited evidence suggests that female resident physicians are more likely to be misidentified as non-physician team members, with potential negative implications for wellbeing. The prevalence and impact of role misidentification on the trainee experience in surgical as compared to nonsurgical specialties is unknown. METHODS An anonymous electronic survey was distributed to fourteen different residency programs at two academic medical centers in August 2018. The survey included questions about demographics, symptoms of burnout, the frequency of misidentification as another member of the care team, and the effect of misidentification on respondents' well-being. RESULTS Two-hundred sixty out of 419 (62.1% response rate) resident physicians completed the survey, of whom 184 (77.3%) reported being misidentified as a non-physician at least weekly. Female sex was associated with a significantly increased odds of being misidentified at least weekly (adjusted OR 23.7, 95% CI 10.9-51.5; p < 0.001), as was training in a surgical program (adjusted OR 3.7, 95% CI 1.7-8.0; p = 0.001). Frequent role misidentification was associated with burnout (OR 2.6, 95% CI 1.2-5.5; p = 0.01). In free-text responses, residents reported that being misidentified invoked a sense of not belonging, emotional exhaustion, and interfered with patient communication. CONCLUSIONS Role misidentification is more prevalent among female residents and surgical residents, compared to male residents and nonsurgical residents, respectively. Physician role misidentification is associated with burnout and has negative implications for resident wellbeing; interventions to reduce role misidentification are needed.
