Thank you for your interest in our article. The data presented1were part of sequential series of studies performed independently that evaluated the risk of burnout in department chairs and then program directors and more recently anesthesiology residents. The survey tool for the program director survey was similar to that used for the chair survey except that faculty  and resident  were used in place of resident  and dean  in place of chairman  in sections 2 and 4 of the survey and chair  replaced program director  throughout.

We found that program directors exhibited burnout to a degree similar to that of chairs, with 52% of the respondents exhibiting moderate to high burnout risk. Risks to the development of burnout in the program directors were slightly different from those of the chairs and included disputes with the chair and Accreditation Council of Graduate Medical Education dispute issues. It is conceivable that chair burnout could affect the program director responses because burnout in the workplace has been recognized to spread among coworkers.2Because the surveys were delinked, we were unable to test the cross-association of chairs and program directors or the potential that the same individual served both roles. We did not receive any comments regarding dual responsibility roles of the respondents and can only speculate that a chair who also serves the role of program director would be facing extreme stressors and could be at a high risk of burnout.

*Northwestern University Feinberg School of Medicine, Chicago, Illinois. r-mccarthy@northwestern.edu

1.
De Oliveira GS Jr, Ahmad S, Stock MC, Harter RL, Almeida MD, Fitzgerald PC, McCarthy RJ: High incidence of burnout in academic chairpersons of anesthesiology: Should we be taking better care of our leaders? Anesthesiology 2011; 114:181–93
2.
Hyman SA, Michaels DR, Berry JM, Schildcrout JS, Mercaldo ND, Weinger MB: Risk of burnout in perioperative clinicians: A survey study and literature review. Anesthesiology 2011; 114:194–204