• 1 Department of Medicine, National University of Singapore, Singapore
  • 2 Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore
  • 3 Department of Surgical Intensive Care, Singapore General Hospital, Singapore
  • 4 Health Services Research Unit, Singapore General Hospital, Singapore
  • 5 School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
  • 6 Division of Gastroenterology, Department of Medicine, Mahidol University Faculty of Medicine at Siriraj Hospital, Bangkok, Thailand
  • 7 Section of Advanced Endoscopy, Division of Gastroenterology, Department of Medicine, Philippine General Hospital, Manila, Philippines
  • 8 Faculty of Medicine, Division of Gastroenterology, Department of Internal Medicine, Cipto Mangunkusumo National General Hospital, Universitas Indonesia, Jakarta, Indonesia
  • 9 Gastroenterology Unit, Department of Medicine, RIPAS Hospital, Bandar Seri Begawan, Brunei Darussalam
  • 10 Department of Medicine, University of Malaya, Kuala Lumpur, Malaysia
  • 11 Department of Anaesthesiology, Sengkang General Hospital, Singapore
  • 12 Department of Medicine, Division of Gastroenterology and Hepatology, National University Hospital, Singapore
J Gastroenterol Hepatol, 2021 Nov;36(11):3056-3068.
PMID: 34159640 DOI: 10.1111/jgh.15594


BACKGROUND AND AIM: The coronavirus disease 2019 pandemic has impacted gastroenterology practices worldwide; however, its protracted effects within Southeast Asia were unknown. The primary aim of the study was to determine the impact of the pandemic on clinical demands including burnout among gastroenterologists within the region. The secondary aim was to identify risk factors for burnout and determine regional stressors.

METHODS: This was a mixed-methods study. Gastroenterologists were surveyed electronically between September 1 and December 7, 2020, via gastroenterology and endoscopy societies of Brunei, Indonesia, Malaysia, Philippines, Singapore, and Thailand. Quantitative and qualitative data were collected. The 22-item Maslach Burnout Inventory-Human Services Survey (MBI-HSS) was used to detect burnout. Quantitative data were non-parametric; non-parametric methods were used for statistical comparisons. Logistic regression was used to determine risk factors for burnout. Content analysis method was used to analyze qualitative data. Ethical approval was obtained.

RESULTS: A total of 73.0% reported that they were still significantly affected by the pandemic. Of these, 40.5% reported increased workload and 59.5% decreased workload. Statistically significant differences in weekly working hours, endoscopy, and inpatient volumes were present. No differences were observed in outpatient volumes, likely because of telemedicine. Burnout was common; however, 50.1% of gastroenterologists were unaware of or did not have access to mental health support. This, as well as depression, being a trainee, and public sector work, increased burnout risk significantly.

CONCLUSION: The effects of the pandemic are multifaceted, and burnout is common among Southeast Asian gastroenterologists. Safeguards for mental health are suboptimal, and improvements are urgently needed.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.