M. M. Symer1, A. Watkins1, H. Yeo1 1Weill Cornell Medical College,New York, NY, USA
Introduction: Burnout is a syndrome of depersonalization and emotional exhaustion that is associated with absenteeism and medical errors. Longitudinal studies in burnout are lacking, and the extent to which burnout fluctuates in individuals is unknown. The current gold-standard survey instrument of burnout, the Maslach Burnout Inventory (MBI), is not specific to surgeons and does not help identify sources of burnout.
Methods: A prospective, longitudinal cohort study of categorical general surgery residents at a single institution was performed over 6 months. Residents were surveyed about their attitudes toward burnout, degree of depression, and current quality of life. Residents were also surveyed with the MBI and a novel, surgery-specific burnout questionnaire. The 34-item novel burnout questionnaire was developed by literature review, informal interviews, and pilot testing with faculty and residents. Included questions related to degree and common sources of burnout. Internal consistency and correlation with the MBI were assessed. Overall prevalence of burnout as well as change in depersonalization and emotional exhaustion at both time points were calculated and correlated with demographic features.
Results: 32 residents participated in the study. At the midpoint 100% of residents were classified as having high burnout in at least one MBI domain, 35% had high burnout in 2 domains, and 12% were classified as having high burnout in all three domains of the MBI. 32 (68%) of eligible residents participated in the study. Residents were mostly white (n=26, 78%), and 56% were men. Most (81%) felt that burnout was a problem which should be addressed. Burnout was highly prevalent at baseline, with 75.9% having high emotional exhaustion. At the start of the study the average emotional exhaustion MBI score was 29 (SD 5.4), and three months later the average score was 27 (SD 8.0; p=0.24). Residents reported a baseline average quality of life of 6.3 out of 10 (SD=2.3), and this also did not change during the study period (p=0.93). Internal consistency of the novel surgery-specific burnout survey was acceptable, with Cronbach’s alpha of 0.76. In survey responses (Figure 1: Major themes and categories of stress and support from qualitative survey responses), residents cited time pressures as the major driver of burnout, and n=31 (97%) agreed that lack of time prevented them from taking better care of themselves.
Conclusion: Burnout is a highly prevalent but relatively stable phenomenon among general surgery residents, and time constraints contribute the most to burnout. The practice environment and institutional culture are also important contributors to burnout. These areas are key avenues for the improvement of burnout in residents.
