INTRODUCTION: Burnout among physicians affects mental health, performance, and patient outcomes. Here we examine psychological characteristics that may contribute to burnout vulnerability and resilience in a nationally representative group of surgical trainees. METHOD(S): An online survey was distributed in September 2016, to all trainees at ACGME-accredited general surgery programs. Burnout was assessed with the abbreviated Maslach Burnout Inventory. Stress, anxiety, depression, resilience, mindfulness, and alcohol use were assessed and analyzed for prevalence. Logistic regression analysis was used to determine magnitude of presumed risk and resilience factors. RESULT(S): Surveys were completed by 589 surgical residents. Prevalence of burnout was 52% and varied by training level, mostly driven by emotional exhaustion. Burnout and distress symptoms were alarmingly high among PGY3s (burnout 53%, high stress 80%, moderate to severe depression 34%, suicidal ideation 18% and alcohol misuse or abuse, 38%), but decreased in later years. Regardless of year, higher burnout was associated with higher distress symptoms. Burnout was predicted by high perceived stress (odds ratio [OR]=4.45, p<0.001) and depression (OR=10.1, p<0.001). In contrast, dispositional mindfulness was associated with less risk of burnout (OR=0.84 p=0.000). Depersonalization was associated with lower distress symptoms (p<0.001), was less likely in females (OR=0.39, p=0.001) and less likely with higher mindfulness (OR=0.88, p=0.001). CONCLUSION(S): Profound distress is experienced in surgical training, particularly in PGY3. Stress and burnout have a direct relationship and both increase the risk of distress symptoms. Higher mindfulness is associated with lower risk of burnout and distress symptoms, highlighting the potential of mindfulness as a component of stress resilience training.
Lebares, C. C., Guvva, E. V., Allen, I. E., Ascher, N. L., O’Sullivan, P., & Epel, E. S. (2017). Burnout in US Surgery Residents: Do Year of Training and Mindfulness Matter? Journal of the American College of Surgeons, 225(4), e20. https://doi.org/10.1016/j.jamcollsurg.2017.07.575